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Saturday, November 22, 2008

For Better or Worse?

Now that I have titered down to the lowest dose of Prednisone, I have gone off the pills completely. So, here I am watching and wondering if this will have any significant change in how my mouth will be. Will it get worse again? I hope not. Will it remain the same, or get better on it's own? I hope so.

With autoimmune diseases like this, it is hard to determine when one will be in remission and when flare ups will occur. In my case where the Lichen Planus has gone beyond just being some lacy white designs on the insides of my cheeks to full blown erosions, it becomes more and more tricky to control.

One has to understand how the layers of skin function. When the Lichen Planus gets to the point where the inflammation (auto immunity) erodes the skin, the layers separate and the top layer of skin is actually sloughing off. Just like when a cancer patient has received Chemo, the mucosa sloughs off. The treatment for chemo mouth is palliative. Treat the pain by offering mouth swishes to numb it or coat the rawness until the patient goes off the chemo and the damage can be healed by the normal process that the skin goes through to renew itself.

With Erosive Oral Lichen Planus, the layers of skin keep sloughing off, but do not naturally heal themselves. Treating with numbing medicine, of course, helps the pain, but it does nothing to cure the cause of the problem.

The cause of auto immune diseases are very complex. Why does a person who has spent all their life without an auto immune disease suddenly have an onset of OLP? I had one auto immune disease that showed up when I was about sixteen years old. It was called Alopecia Areata. I lost hair on my scalp in the shape of round circles that got to be about the size of a quarter. Sometimes I would have just one, sometimes a few more. Of course, beauticians as well as doctors would say, it's caused by stress.

Saying a medical condition is caused by stress is ridiculous in my opinion. We have stress of all sorts in our lives every day. Let's say, for example, that driving in traffic is stressful. So, are we saying that driving in traffic causes an auto immune disease? If that were the case then the auto immune disease would never go away as long as the patient was driving. And if the patient actually stayed home and did not drive anywhere, what would then, be the explanation of a flare up of the disease? The fact that the patient is isolated at home? Give me a break!

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