DEAR DR. DONOHUE: I am a 70-year-old woman recently diagnosed with lichen sclerosus et atrophicus. Will you please provide information on this disease? Is it an autoimmune disease? If not, then how does one get it? Is it more prevalent in menopausal women?

I was told to restrict carbohydrates, sugars and wine almost to their exclusion. How do these items affect this disease? — M.D.

ANSWER: Doctors who pioneered the field of dermatology must have been lovers of the Latin language. Dermatological conditions have some of the longest and most arcane names in all of medicine. This is an example. The Latin word “lichen” refers to a tree moss. “Sclerosus” is “hardening.” ”Atrophicus” refers to a thinning and wasting away of the affected skin.

Lichen sclerosus (you can skip the “atrophicus”; most doctors do) affects men as well as women, but most patients are female, and most get it either before puberty or after menopause. It is an autoimmune disease. At times, it’s also associated with other autoimmune diseases, like some thyroid gland illnesses and vitiligo, patches of skin that have lost their pigmentation. Furthermore, antibodies — ammunition made by the immune system — are found in the blood of those with this illness.

An outbreak starts as white, many-sided, flat bumps most often on genital skin but sometimes in other locations. The involved skin begins to wither. It becomes wrinkled and thins. Itching can be intense, and a burning sensation is frequently present.

Lichen sclerosus isn’t a seldom-seen condition. I thought it was. Judging by the amount of mail asking about it, I have changed my mind.

Strong cortisone creams like clobetasol (Temovate) usually can control this condition.

I don’t know why the dietary changes were suggested. Ask the person who made them, and then will you tell me the reason?

DEAR DR. DONOHUE: I have an ingrown toenail that’s uncomfortable, but I know it will get worse. I saw a podiatrist, who suggested a shot to numb the toe and then cut out part of the nail. The problem is that I hate needles and am a big baby. Comments on the Internet say how horrible the shot is. Even my mother said it was the most painful shot she’d ever had. Any suggestions would be appreciated. — R.D.

ANSWER: The edge of your toenail is growing into the adjacent skin. If you want to try to free it, go about it like this: Soak your foot in warm, soapy water for 15 minutes. Then take dental floss and pry the edge of the nail from the skin into which it’s embedded. Take a small wad of cotton from a cotton ball and introduce it under the edge of the nail. Remove the cotton in two or three days.

If all of this is too much, go back to the podiatrist. Numbing the toe — and I speak as a patient — isn’t a horrible procedure. I wouldn’t base anything on comments from the Internet. Don’t go to your mother’s doctor.

DEAR DR. DONOHUE: Please discuss bath salts. I was with a group of friends who were talking about them. I thought they were talking about something to put into bathwater. When I told them, they dissolved into hysterical laughter. I was told bath salts are the latest rage in drug use. — K.O.

ANSWER: Bath salts contain either methylenedioxypyrovalerone (MDVP) or methcathinone (mephedrone). MDVP produces a high by stimulating the brain. Users look like they are under the influence of alcohol. Mephedrone is a close relative of a substance found in the African khat plant. It affects the brain in a way similar to amphetamine.

Last year, both of these substances were declared illegal in the United States.

Overdose of bath salts can lead to hallucinations, delusions and elevate blood pressure. People should steer clear of them.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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