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Grand Strand Dermatology, LLC

"Love The Skin You're In"

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9400 Frontage Road (Hwy 17 Bypass)

Murrell Inlet, SC 29576

(843) 215-1100

933 Medical Circle

Myrtle Beach, SC 29572

(843) 215-1100

843-215-1211

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  • Home >
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  • Lichen Planus

Lichen Planus

  • Created in Pamphlets

Lichen planus is a skin disease that also is common inside the mouth. It also can affect your genitals, scalp, fingernails

and toenails.

WHAT DOES LICHEN PLANUS LOOK LIKE?

On each part of the body, lichen planus looks somewhat different. The following describes what you can see on each part of the body.

Skin

On the skin, you will often see a few purplish shiny bumps. These bumps can be very itchy. People also see fine, white, lacy-looking lines on the bumps. If bumps continue to appear in the same place, thick patches of rough, scaly skin can develop. The most common places to have bumps are the wrists, lower back, and ankles.

Mouth

Oral lichen planus can form on the gums, tongue and insides of the cheeks. Sometimes it affects the lips. It most often causes lacy white lines or raised white spots on the insides of the cheeks. A person also can have white patches.

Sometimes it can look like redness and swelling inside the mouth. Painful sores and ulcers also can develop. The mouth can feel tender or burn.

Lichen planus
Lichen planus

Genitals

When lichen planus develops on the genitals, it causes the purplish bumps seen on the skin. Like the skin, these bumps can itch. Women get lichen planus on their external genitals and the mucous membrane that lines the vagina. The mucous membrane becomes red and raw. Like the skin, these bumps can itch and painful sores and scars can develop.

Nails

People who have lichen planus on their skin also may develop it on their nails. Sometimes more than one nail is affected. The affected nails lose their shine. They can split and thin. Grooves and ridges can appear. Nails can

darken, thicken, and separate from the nail bed. A nail may stop growing or fall off. While rare, a nail can disappear, permanently leaving the person without a nail.

Scalp

This form of lichen planus is uncommon. It is called lichen planopilaris or LPP, and often begins with small bumps on the scalp. Redness, itch, and scaly patches can develop. The scalp may feel tender or burn. Some people see noticeable hair loss, which can be temporary or permanent if scarring develops.

WHO GETS LICHEN PLANUS?

Anyone can get lichen planus. It is most common in middle-aged adults. Women get lichen planus in their mouths more often than men do.

WHAT CAUSES LICHEN PLANUS?

The cause of lichen planus is not understood. Lichen planus is not a type of cancer, nor is it contagious.

Lichen planus might be an autoimmune disease. This means that the body’s immune system mistakes a part of the body as a foreign object. When this happens, the immune system starts to attack the skin, causing lichen planus.

Sometimes the immune system reacts this way because a medicine or a medical condition, such as an infection, triggers the reaction. If this is the reason for your lichen planus, an accurate diagnosis is essential. You may need to change medicine or treat the related medical condition.

There may be a link between lichen planus and infection with the hepatitis C virus. Many people with hepatitis C also have lichen planus. Your dermatologist may check to see whether you have this virus.

A prompt diagnosis and treatment are important for other reasons. Treatment can prevent the disease from worsening. When symptoms bother you, treatment can bring relief and speed healing.

HOW DOES A DERMATOLOGIST DIAGNOSE LICHEN PLANUS?

A dermatologist often can tell whether you have lichen planus by examining your skin, nails, and mouth. To make sure that you have lichen planus, a dermatologist may need to perform a biopsy. This is a medical procedure done in the dermatologist’s office that will remove a piece of skin to be examined under a microscope. Your dermatologist may call this a biopsy. Sometimes, you may need blood tests to rule out other diseases.

Your dermatologist also may ask what medicines you take. Some people develop an allergic reaction to a medicine. This reaction can look like lichen planus. If this happens, you may need to change medicines.

Your dentist may find lichen planus in your mouth during a checkup and encourage you to see a dermatologist. A very few people develop an allergic reaction to dental fillings that can look like lichen planus inside the mouth. If your dermatologist suspects this, you may need allergy testing.

HOW IS LICHEN PLANUS TREATED?

There is no cure for lichen planus. It often goes away on its own. Mild cases on the skin may not need treatment. Many cases of skin lichen planus go away within two years. About 1 in 5 people will have a second outbreak. In some people, lichen planus may come and go for years.

Lichen planus
Lichen planus

Lichen planus in the mouth often lasts longer than lichen planus on the skin. In the mouth, it can be harder to treat. Treatment is recommended for lichen planus of the mouth and genitals. If you have pain or a serious case, treatment is essential.

There is no U.S. Food and Drug Administration (FDA) approved treatment for lichen planus. The following treatment options may be offered by your dermatologist and may provide some relief:

• Corticosteroids:

  • Topical (applied to the skin): Cream or ointment to reduce swelling, redness, and itch
  • Oral (taken by mouth) or Injection: Pills (such as prednisone) or shots can help when lichen planus lasts a long time or a patient has many bumps or painful sores
  • PUVA therapy: A type of light treatment that can help clear the skin
  • Retinoic acid: Applied to the skin or given as a pill to help clear the skin
  • Tacrolimus ointment or pimecrolimus cream: Commonly used to treat another skin problem, eczema, has also been shown to be beneficial in the treatment of lichen planus

Sometimes lichen planus can be stubborn. Your dermatologist may combine two or more treatments to help clear your signs and symptoms.

As lichen planus heals, it often leaves dark brown spots on the skin. These spots are harmless and may fade without treatment. If they do not, see your dermatologist for treatment options.

HOW DO I MANAGE MY LICHEN PLANUS?

  • Follow your dermatologist’s advice on coping with lichen planus. Your dermatologist can help you control this common disease and feel
  • Apply and take medicine as directed. While many people do not need treatment, if you received medicine to treat lichen planus, following directions and taking it as directed will increase the effectiveness of your
  • If you have lichen planus on the skin, try not to scratch. Ask your dermatologist about ways to prevent
  • If you have oral lichen planus,

• Limit tobacco and alcohol use or quit altogether.

Oral lichen planus increases your risk for oral cancer. If you smoke, chew tobacco, or drink, this increases your risk even more.

• Stop eating foods and drinking beverages that can worsen lichen planus in the mouth.

These include spicy foods, citrus fruits and juices, tomatoes and foods made with tomatoes, snacks that are crispy and salty, and drinks that contain caffeine.

A board-certified dermatologist is a medical doctor who specializes in diagnosis and treating the medical, surgical, and cosmetic conditions of the skin, hair and nails. To learn more about lichen planus or find a dermatologist in your area, visit aad.org or call toll free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.
Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017
AAD Public Information Center: 888.462.DERM (3376) AAD Member Resource Center: 866.503.SKIN (7546) Outside the United States: 847.240.1280

Web: aad.org

Email: [email protected]

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Skin Cancer Removal Procedures

Skin Cancer patients can expect a surgical plan to remove their skin cancer based on the location , size, and type of tumor. Most treatments to remove cancerous lesions can be conducted under local anesthesia.

 

The Skin Cancer is removed with a Surgical tool called a curette with a hoop or scoop on the end for scraping. An electric current is then applied to the area through a needle-like electrode designed to kill the remaining cancer cells and reduce bleeding.

After care instructions: The ED&C site must be kept clean if it is to heal rapidly. It is a small open wound which may or may not leave a scar. To clean the site, follow these instructions

First Wash Your Hands With Soap and Water

1. Remove Initial dressing in 24 hours.

2. Wash the area with soap and water twice a day. Apply a thin film of Aquaphor or Vaseline and cover with a fresh bandage until healing has occurred. This may take up to 2/4 week, depending on size of the wound and location.

3. Do not use Neosporin or other over the counter topical antibiotics as allergies to these medications are quite common and they can slow down healing.

4. Keep wound moist with Vaseline and band-aid, as stated in number 2. A scab or leaving it open to the environment will slow down healing.

It is normal for the site to become puffy, reddened, or irritated. However, if the site is warm to the touch, oozing, or severely reddened or very sore, you need to contact the office at (843)215-1100.

 

The skin cancer growth is removed with surgical excision by cutting or shaving it out of the skin with a scalpel. Local anesthesia is used to numb the affected area. Depending on the type of tumor, our surgeons my remove a certain amount of surrounding tissue. 

After Care Instructions: First Wash Your Hands With Soap and Water

1. You may apply an ice pack following surgery. Apply the ice pack on for 20 minutes, and then remove for 20 minutes, and repeat the process as needed. 

2. Remember, applying direct pressure to the surgery site stops bleeding.

3. You may take Tylenol for Pain if needed.

4. Leave the wound dressing on for 24 hours

5. While showering, remove your current dressing and clean your wound, and the remove for gently with warm water and soap to remove any dried blood and prevent scab formation.

6. Apply Vaseline ointment at least one time daily, and cover the entire wound with a band-aide or gauze dressing.

7. On your scheduled day of suture removal, cleanse the wound, and leave the area DRY(do not apply any ointment) and return to our office at your scheduled time to have the sutures removed

8. If your wound is in the beard area on your face or other area where you normally shave, please avoid shaving near the wound.

9. If the surgical site starts to bleed excessively and doesn't stop with applied pressure for 15 minutes, the dressing become saturated with blood. If there is excessive swelling or the site become inflamed and warm to the touch. Call the office at 843-215-1100

 

The surgeon removes the visible skin cancer and come surrounding tissue via and incision. The removed tissue is frozen, dyed, and evaluated under a microscope by a pathologist to see if the cancer has been removed entirely. If cancerous cells are still present, the process of excision and evaluation is repeated until the cancer is no longer detected. The diagnosis of the removed tissue is made in real-time, so the patient can be confirmed cancer-free the same day. The process can take several hours to fulling remove the cancer.

After Care Instructions: First Wash Your Hands With Soap and Water

1. You may apply an ice pack following surgery. Apply the ice pack on for 20 minutes, and then remove for 20 minutes, and repeat the process as needed. 

2. Remember, applying direct pressure to the surgery site stops bleeding.

3. You may take Tylenol for Pain if needed.

4. Leave the wound dressing on for 24 hours

5. While showering, remove your current dressing and clean your wound, and the remove for gently with warm water and soap to remove any dried blood and prevent scab formation.

6. Apply Vaseline ointment at least one time daily, and cover the entire wound with a band-aide or gauze dressing.

7. On your scheduled day of suture removal, cleanse the wound, and leave the area DRY(do not apply any ointment) and return to our office at your scheduled time to have the sutures removed

8. If your wound is in the beard area on your face or other area where you normally shave, please avoid shaving near the wound.

9. If the surgical site starts to bleed excessively and doesn't stop with applied pressure for 15 minutes, the dressing become saturated with blood. If there is excessive swelling or the site become inflamed and warm to the touch. Call the office at 843-215-1100

 

Typically used to treat minor skin cancers and pre-cancerous lesions, cryosurgery involves the use of liquid nitrogen to freeze and destroy the cancer cells. The procedure, also known as cryotherapy is repeated until the affected area no longer shows signs of pre-cancer or cancer.

After Care Instructions: 

1. You do note need to cover the area treated, unless instructed to do so.

2. The discomfort is temporary but may last for 10-30 minutes after treatment.

3. the area may appear red for up to one hour after freezing but often returns to normal color within 10-15 minutes.

4. A blister may form within 24 hours of treatment. this may be clear fluid filled or blood filled, if it is uncomfortable, you may drain it by using a clean needle cleansed with alcohol. If this is done, cover with a Band-Aid and Vaseline ointment for approximately one week. This bandage should be changed daily. 

5. Sometimes a scab will will form over the area treated. This will come off on its own and does not need to be covered.

6. If you have any questions or concerns after reading the above information, please do not hesitate to call our office at 843-215-1100



Side Effects of Skin Cancer Removal 

With any kind of skin cancer removal, scarring is likely to occur. Incision sites may be sore, red, or drain small amounts of fluid. Healing will continue for weeks and even months after your surgery, incision lines will fade and continue to improve. Sun exposure on wounds and scar lines can result in irregular pigmentation or cause the sight to become red, raised, or dark, so patients should follow post-op preventative instructions carefully. 

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