Category Archives: Lichen planus

I havn’t posted on lichen planus for many months:

Lichen planus

I havn’t posted on lichen planus for many months: for you out there who have this (as I do), the years just go buy…and for me….stress is an instigator. best to you all.

I am studying “lectins” in general and know in my head somewhere that there is a connection between the lectins (involved in innate immunity) that i am looking at at any given moment might very well be critical) Little consolation from the itch.

I may have read this article before, but in todays search it seems like a good one.

Cant wait to see if the tooth that had a root canal (failed) and metal build up (now pulled out) will relieve my symptoms.  Hopefully.

Blood glucose levels and lichen planus

Lichen planus

I just found this pdf, (attached below) and in my own experience with lichen planus have seen some carbohydrate metabolism issues, though mainly I get more hypoglycemic (self diagnosed, it might be hyperglycemia) than I have in previous years. Also, just the level of fatigue is increased (but also, i am 74 and expect to be able to easily run marathons)..Keeping all in perspective, i am just trying to get to the best way to live with this diagnosis. IJCED_3(1)_14-16> find pdf here
Five years down the road (it is now May 2023): This has never gone away, so i guess i am on the long end of this disease (commented at 7 yr in the literature) than the short end (1 year) and for me “stress” is certainly a factor, and there is a possibility that working with concrete and mortar might make things worse? No reasons for that thought except coincidence? since I have spent the winter and early spring patching basement holes, and tiling a bathroom. Who could make a connection? no clue.

Injury to superficial skin (like scraping injuries that remove epidermis) are definitly a contributing factor.

C reactive protein

Lichen planus

Looked up to see whether this particular protein (a product of the liver) is elevated in lichen planus patients, and it was….. and while the linked article here states that this is correlated with an increase in cardiac rhythm…. i bet it is not the disease itself but the inflammation in general… as they say this is also true for other diseases.  So i have to agree, this is a stressful disease….  the association shown here in a small study is probably a “whole body” response to having an immune disease, maybe any disease, or in other acute inflammatory states.

wikipedia says: C-reactive protein (CRP) is an annular (ring-shaped), pentameric protein found in blood plasma, whose levels rise in response to inflammation. It is an acute-phase protein of hepatic origin that increases following interleukin-6 secretion by macrophages and T cells. Its physiological role is to bind to lysophosphatidylcholine expressed on the surface of dead or dying cells (and some types of bacteria) in order to activate the complement system via C1q.

CRP is synthesized by the liver in response to factors released by macrophages and fat cells (adipocytes). It is a member of the pentraxin family of proteins. It is not related to C-peptide (insulin) or protein C (blood coagulation). C-reactive protein was the first pattern recognition receptor (PRR) to be identified.

The protein itself is beautiful…. i think i might just honor it by constructing a stained glass rose window pattern.  ha ha.  thank you wikipedia for the image.

Different effects from different types of trauma

Lichen planus

I have casually logged into my mind what kinds of trauma to the skin turn into lichen planus lesions and which do not.  For starters, it seems that trauma from items which have antigenic properties (eg cat scratch, dog toenail scrapes, rubbing from a dog leash over the wrists) become real lichen planus lesions, where as more sterile injuries, bumps, pin pricks (as in sewing) dont have the same tendencies.  Another mystery is why “on me anyway” spider bites (1/2 inch red area with swelling and a central darker dot) don’t turn into lichen planus lesions.

I had a biopsy of a 30 or 40 year old lesion on my leg that was left over from small pox vaccination (which at that point in time was a conventional remedy for apthous ulcers, since it was believed there was some cross immunity achieved — that is not done any more, but because other herpes type viruses  can show post-infection increase in lichen planus i will be curious to see if that pathology matches others taken in my case.

Also noted, the impact of chemicals as instigators of lesions at points of trauma seems to be prevalent, eg, bandage adhesives.

While this disease requires the utmost of patience, and heroic efforts are required to keep from scratching, maybe there is healing somewhere for some people and at some point treatments will be found…. likely like one will have to say… I am a “recovering” lichen planus patient, as i don’t think the basic predispositions may be only genetic (as writen in genetic code or epigenetic modifications)  ha ha.  or not so ha ha but has an environmental (environment in the greatest sense that includes, chemicals, irritant compounds, man made compounds, diet, stress and the whole nine yards).  My sympathies to all you out there with this disorder. What is clear that diseases processes and problems that don’t threaten “life” get sent to the back burner in terms of research.

Pineapple and swiss cheese

Lichen planus

Who knew? Ha ha… after a sleepless itchy night of tossing and wondering and trying to figure out what in the world triggered this insomnia i remembered two things that I had eaten late evening and before bed.  Fresh pineapple and swiss cheese.  I googled it, and found some interesting stuff, some stuff from well known nutritional voices, that there are people who are sensitive to “amines”. So i already knew this, i never drink wine because of the amines (actually I learned that in my 20s that only gin did not give me puffy eyes and a hangover, i don’t really drink anything now) and i had an idea that cheese might not be something to eat late at night. sleepless night overload with histamines

But what I found was that “ripened cheeses…like swiss” can have a LOT of amines – histamine in particular – and this depends upon how long it is aged and other things and it can vary quite a bit between products and between batches…. OK so no more cultured cheese in the early evening so I don’t have so much circulating histamine,  but what i also found was that pineapple (who knew) releases histamine. Ha ha… double bad…. lots of amines by swiss cheese, lots of histamine release by pineapple.

If you have some amine (i guess this might include glutamine) sensitivity, and you eat a lot of pineapple and cultured cheese before bed, then you might have that “restlessness” and “sleeplessness” that feels a lot like MSG overload.

Just a heads up for those of you who, like myself, might have an “itchy” disease like lichen planus…. and you are already dealing with itching…. you don’t want to increase the amount of histamine you take in or release……!!!

Lichen planus: a case report

Health - opinions, Lichen planus

I am going to begin blogging data about my own  case… ultimately with data and slides and perhaps I can submit it to a journal where others can benefit from my observations.

So beginning with, yikes, i don’t like this condition, ha ha, itching is a seriously annoying entity, and scratching is not an option.  Basically I am not one who has ever been able to use, or even consider using, skin creams, antiaging formulas, junk for tanning, or removing spots. I have skin which is genetically “poor” by all standards so had I been raised in an age where there were products for sensitive skin, and had there been much knowledge about skin care in general (UV A, B, and C and their potential for causing skin aging and cancer) and had I been born to parents (whom I do not criticize here as the data were not yet defined) with any biological knowledge, things might have ended up differently..but they didn’t.

My children inherited their father’s skin for all I can determine, olive complected and not prone to burning and sun damage…so that is a plus, nevertheless I am/will/have  informed them all of what I understand about skin types and predispositions.

While this is just  “tip” for now…..  the itching of lichen planus is not easily remedied. I have found one very interesting thing (at least i think it is interesting and it works for me). Mary Kay cosmetics makes a buffing cream…I haven’t even read the contents, but i had a tube in my closet for 20 years at least and got it out about a week ago and wondered if it would help take the keratin layer off my lichen planus lesions.  What I found really startled me…in fact using this buffing cream in a soft circular motion over the lesions actually did NOT MAKE ME ITCH…. but it did give me some relief.  How odd is that.  In place of scratching, try using this buffing cream and cold water rinsing…. ha ha… who knew.

Anamnestic – does this describe some lichen planus variants? Random thoughts

Lichen planus, Ultimate order, the cell

 

The following paragraphs are just random thoughts and articles that might shed some light on the disease that is lichen planus (thinking too some variants of the disease like hypertrophic lichen planus and lichenoid drug-induced eruptions (which i would rename lichenoid like dermatoses) with various environmental triggers. I found a relatively old publication in the 1990s that clearly felt environmental factors were important in LP, but with passing years and changes in research-topic “runway-fashions” the environmental influence gets less attention.

Reading an article on histologic distinctions between lichen planus and lichenoid drub-induced dermatitis (link reference given previously) I think it is a perfect description of what I have experienced and a perfect expression of the gene environment interactions that go along with other cases where the immune system decides to make massive amounts of antibodies to a “wrong thing” — as the online definition of anamnestic states so beautifully “an enhanced reaction of the body’s immune system to an antigen that is related to an antigen previously encountered”

I cant wait (but am apparently going to wait a long time) for my condition to clear so i can go back and test if my assumption about mortar, grout, cement, concrete and additives are the “guilty-by-association antigens” that cause this disease.

AND here is a new tack. duh, i should have thought this up a long time ago. I have been slightly aware that potatoes (not sweet potatoes or yams) might cause an increase in itchiness of my lichen planus spots. I did cut out potatoes and peppers for a while, but then on June 6 2018 (that is about 9 months into the flare up of this disease in my) I went back to eating peppers tomatoes and potatoes (all nightshade family members). Yesterday i cut out potatoes again…. so Then i googled, nightshade plants and immune response and find again, what i knew once, that those have “lectins”. Make the connection here. Lung cells (in particular, alveolar type II cells) secrete surfactant protein A… the latter is named a surfactant protein, and it does in fact participate in the formation of tubular myelin in the alveolar spaces but one can live just fine and had sufficient lung function WITHOUT surfactant A. That said, there are immune consequences because surfactant A is a C-type lectin (lung reaction allergens) and

“Antigen-presenting cells can capture antigens that are deposited in the skin, including vaccines given subcutaneously” (Flatcher et al, J. Invest. Derm. 2010 Mar;130(3):755-62. doi: 10.1038/jid.2009.343).
Aside: shame on whomever called lichen planus a benign situation… ha ha.. clearly never had it. Bless the person who describes the causes of lichen planus as “undefined” because clearly there is a cause, and likely a multitude of causes, and I add, many are going to be environmental… mistaken identity immunity, or inappropriate immune responses. Bless the guy who mentions adhesion molecules in this disease…. i have no clue how the extracellular adhesion molecules in epidermis can tell the difference between “sheer” (rubbing) and patting (e.g. patting dry an area of lichen planus eruptions) but the cells know… a tiny bit of sheer tension and it triggers highly intense itching. It only took one google search to find this article which actually mentions extracellular adhesion molecules in Pemphigus, so this is not far from responses in lichen planus.

And another article here which describes roles for langerhans cells… goodness, maybe direct access of environmental materials (as in my case, cement, mortar, thinset mortar grout, and whatever was present on acorn debris thrown up into my shins from my lawnmower) was opsonized by the langerin (C-type lectin) surface protein in my epidermal langerhans cells… ha ha… so much fun to learn this stuff… and to suppose what processes might have occurred.

One observation is that LCs induce some form of contact hypersensitivity though the immunostimulatory capacity of langerhans cells depends on the quality and quantity of the environmental stimuli. “Immune responses can be markedly enhanced when antigens are ‘‘targeted’’ to uptake receptors on dendritic cells and administered together with  inflammatory stimuli.” (quoted from an article  “Changing Views of the Role of Langerhans Cells NikolausRomani, Patrick M.Brunner, GeorgStingl”
I also saw where antigens (example was arsenic) could be captured by langerhans cells directly is damaged skin (like dry skin? perhaps)

More discussion on reading my slides: along with a big dose of gender and age bias from the pathologist

Health - opinions, Lichen planus, Rants, Ultimate order, the cell

I was thinking about the encounter with the derm pathologist at UC last night, and while i would love to mention the name expressly, I am using better judgement and not doing that. There is something about the MD personality that is incomprehensible to me… i was married to an MD (surgeon) for 15 years, I have worked with MDs in some capacity or other for 50 years and of course what I am about to say is a generality. Thinking in generalities is problematic and it allows for bias to creep into thinking, therefore when you read the following, you must know that I am including “SELF” in that group.
Bias exists in science, as it does in all disciplines (and some lack-of-disciplines as well). In the field of microscopy as it began, there was no methodology for quantification and everything one reported in terms of histology was bias: It was biased upon previous readings, on psychological emotional and physical issues present in the slide reader at the time the slides were read, how well the slides were/are prepared, the pressure to read more and more slides faster and faster, and the biggest threat to rational thinking, lack of knowledge. So these are only a handful of really important things that influence how a slides is interpreted. The list is so long that I am not even going to give it the time.
When I began doing microscopy in the late 1960s and early 70s there were new ways to quantify cells, tissues, organelles, etc and I have used, reused, reinvented and recommended those techniques to everyone that I have collaborated with. Help from statistics programs meant that histology could be correlated with other physiologic and biochemical and behavioral measures. That said, not everyone things that morphometry (as it is called) is required for reading slides.
Not everyone even thinks that viewing slides at 100x oil is required for making diagnoses. While I sat at the student scope across from derm pathologist _blabla_ the magnification went to 60x at most, and i think 40x was probably where the objective stayed most of the time…maybe less. That for me is like hitting the tissue with a hammer when tweezers would have been the tool of choice. I asked the question, how do you see mast cells, langerhans cells, basophils, eosinophils, he said “you cant” of course i agree, but flipping the objective to 100 and adding oil would have gone a great way in making those cells visible. Not one question i asked was responded to with any intellectual satisfaction for me, for every suggestion he made i could have quoted the online general source for the same (or better) info. I expected something much more academic… ha ha… i did not expect the brush-off, so clearly signaled, nor the hostility which was directly verbalized to me with the phrase… “for the number of people you contacted” a direct reference to the two months and 10 phone calls required to get a view of MY slides. To end the meeting he put up the slides from a tray from another patient and said i guess you shouldn’t look at these… with that i said… “it is clear you want me to leave” What a bad experience. THis old man, near or in retirement, displayed a shameful bias (you know a generality) to women in science and particularly to me (also retired) that was just ludicrous.
The whole experience in Derm at UC was just not that great….maybe it is all gender and age related bias… ? I expected to be treated like a peer (which i am to him) but instead was treated like a woman whose job it was to wash dishes. How sad. UC has displayed gender bias ever since I was a graduate student…. so in 1968… to 2018, I am not seeing much of the change.