Recurring Blisters That Break, Bleed, Scab. Diagnosed To Be Lichen Planus. Measures To Overcome This?

Posted on Tue, 14 May 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 14 May 2013 Answered on

Tue, 11 Jun 2013 Last reviewed on

Question : I have recurring blisters that break, bleed and scab only to come back in a couple of days. I have been told it is Lichen Planus. What can I use to relieve the pain of these open blisters?

Answered by Dr. Dr. Rahul Kumar (8 minutes later)

Hello,
Thanks for the query.
Lichen planus presents with itch and thick plaques of skin.

Blistering is usually not seen in Lichen planus.

Can you send me a photograph of the lesion.

It will help me in giving a closer diagnosis.

Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rahul Kumar (9 minutes later)

My p/c cannot send pictures. I have seen 2 different dermatologists. One took a biopsy and said it was not cancer but she thought maybe pre cancer and put cold treatment on my lips which burned them. That didn't work. So she prescribed a cream (acid) to put on every night which peeled my lip raw and I had to stop after 4 days as she directed. I couldn't eat or drink it was so bad. Then she prescribed a hydrocortisone to apply. She is not a dr but a dr. assistant. The second dermatologist concluded it was lichen planus which is what the dentist thought it was and gave me cortisone cream to put on but I still have the blisters that break open and hurt. Both said it isn't herpes.

Answered by Dr. Dr. Rahul Kumar (13 minutes later)

Hello,
Thanks for the follow up.
Without photograph, I would have to believe what your other doctors said.

So considering it Lichen planus. The treatment is steroids.

Your dermatologist has given you cortisone, which is a very mild steroid.

According to me you need treatment with Triamcinolone paste, which has a higher potency and hence will give you better relief.

If the lesions are recurring, even oral prednisolone or tab azathioprine can be considered.

Please XXXXXXX your dermatologist and ask him regarding the above medication.

Let me know if you have any other doubt.

Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rahul Kumar (12 minutes later)

Thank you. I already have tried triamcinolone Acetonide USP, 0.1% and b/c it is on the lip the saliva rolls it right off. She then prescribed Hydrocortisone Valerate ointment USP, 0.2% which I use now but continually have the problem. My next step, if you agree, is to completely change my diet. Is this dr. giving me the correct treatment?

Answered by Dr. Dr. Rahul Kumar (11 minutes later)

Hello,
I dont think change in diet will have any benefit.
Treatment is correct but not that potent.

Triamcinolone comes in various forms, it even comes in a sticky gel form which easily adheres to lips. In India it comes with a brand name of Kenacort oral paste.

Hope it is available in your country too.

If you dont get it, oral steroids will be a better option.

Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rahul Kumar (7 minutes later)

Thank you Dr. XXXXXXX I have the dental paste. I will keep that name for the dr. She is Dr. Bhatt, also from India. I apreciate your opinion and suggestion. Thats all for today.

Answered by Dr. Dr. Rahul Kumar (9 minutes later)

You are most welcome.

Wishing you a good health.

Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar