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Suggest Treatment For Lichenoid Dermatitis

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Posted on Mon, 26 Sep 2016
Question: What drug will cause lichenoid photo dermatitis skin reactions?

Lichenoid photo dermatitis looks like round circles all over my body and they itch. Cannot figure out what is causing this. Have changed the washing detergent to what the dermatologist say to use. Also changed body wash as recommended. Have stopped beta blocker med and metformin but this did not help. It goes away for two weeks after taking oral steroid but then returns. I use steroid cream on skin to help with itching. Cannot figure out which drug may cause this.
doctor
Answered by Dr. Dr.Albana Sejdini (2 hours later)
Brief Answer:
A photo of the affected lichenoid dermatitis is needed

Detailed Answer:
Hi my dear,

I understand your concern.

Can you please provide a photo of the affected skin area of lichenoid dermatitis? So, I can analyze the changes myself and give a more precise opinion.

Any skin testing done so far?

Looking forward to have the requested photo in.
Dr.Albana


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr.Albana Sejdini (3 hours later)
Go to http://en.wikipedia.org/wiki/Lichen.planus and you will see a photo of what I have. Dr. XXXXXXX sent a biopsy to lab. Report says vascular interface dermatitis with eosinophils. PAS stain negative for fungal organisms. Negative direct immunofluorescence studies.
Dr. XXXXXXX the findings are not absolutely specific. Processes that can produce these histopathologic findings include a hypersensitivity reaction to an ingested or inhaled allergen such as a drug, lichenoid photo dermatitis, and other less common processes. The presence of eosinophils makes collagen vascular disorders, which can also produce vacuolar alteration of dermal/epidermal junction, much less likely.
doctor
Answered by Dr. Dr.Albana Sejdini (2 days later)
Brief Answer:
Unfortunately, no photo detected at the link to you provided...

Detailed Answer:
Hi back,

I am sorry to admit that I was not able to see the photo at the url you sent in. That is your personal account and photos cannot be viewed in the public.

I'd be happy if you could just upload the photo again or send at the following e-mail address:

YYYY@YYYY

with subject line: "Attn.to Dr.Albana Sejdini"

The presence of eosinophils and vascular interface dermatitis is characterized by infiltrates and vacuolar change at the dermo-epidermal junction, which is typical for erythema multiforme.
While, lichenoid interface dermatitis is characterized by denser, band-like infiltrates which is typical for lichen planus reaction to any external allergen such as medication.

While, vacuolar interface dermatitis are degenerative changes at the dermoepidermal junction, and lymphophatic inflammation at the epidermis and dermis. These changes are typically for the diagnosis of erythema multiforme, lupus erythematosis, or lichen sclerosis.

I'd like to have the full histopathological report to analyze the changes myself.
Thank you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr.Albana Sejdini (3 hours later)
After looking at all the meds I take do you see any that would cause this condition.
You can google the condition and I am sure you will find a photo. XXXXXXX Wilkinson
YYYY@YYYY
doctor
Answered by Dr. Dr.Albana Sejdini (34 hours later)
Brief Answer:
Possibly januvia if started recently...

Detailed Answer:
Hi back,

Sorry for the late reply due to my XXXXXXX clinical overload.

If I do not see the skin affection myself at your body, we cannot judge on what is on the internet.
Specific cases have their own specific features so the treatment is based on clinical observation.

After reviewing your meds, hope there is any improvement after stopping metformin and beta blocker.

As you have a personal history of breast cancer, I'd like to know if you had the strong chemo recently or years back?

if you just started januvia, please discuss with your doctor to stop using it and see if improvement.

The others if started years ago are not to blame. However if under chemotherapy, that can alter your body immune forces and make you more sensitive to various(even common) allergens(including those that have been used for years now).

All the best.
Dr.Albana



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr.Albana Sejdini (14 minutes later)
Had very strong chemo 16 years ago that caused neuropathy in hands and feet. Don't know how to send you a photo of the circles on my skin that itch.
doctor
Answered by Dr. Dr.Albana Sejdini (4 hours later)
Brief Answer:
No problem for photo...

Detailed Answer:
Hi back my dear,

If you can use email, can send at following email address

YYYY@YYYY

with subject line:"Attn. to dr.Albana Sejdini"

No problem if cannot send, don't stress yourself out unnecessarily.

As per your new data, still thinking of weak immune system.

Anyway, discuss with your doctor about stopping januvia first.

I'm still thinking of fungal infection too so another KOH examination of skin scrapping is advised.

All the best and God bless my dear!
Dr.Albana
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr.Albana Sejdini

General & Family Physician

Practicing since :2006

Answered : 7309 Questions

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Suggest Treatment For Lichenoid Dermatitis

Brief Answer: A photo of the affected lichenoid dermatitis is needed Detailed Answer: Hi my dear, I understand your concern. Can you please provide a photo of the affected skin area of lichenoid dermatitis? So, I can analyze the changes myself and give a more precise opinion. Any skin testing done so far? Looking forward to have the requested photo in. Dr.Albana