Lichen Planus
Case Studies
from the
Denver Metro Health Clinic
Case
• 28 year-old African American heterosexual man complaining of a mildly itching rash that started on his penis about 3 months ago and has slowly spread to his extremities and torso
• Sexual history: 2 female partners in past 4 months; no condom use
• No history of previous dermatological conditions
• No known exposures to chemicals or medications
Case
• Inspection:–Multiple papules on penis, scrotum, wrists,
ankles, torso
– Individual papules are purplish in color; flat-topped and angular in shape
–Most papules are covered with a fine, silvery scale
–Buccal mucosae reveal bilateral lacey white patterns
Case
• Relevant lab tests, including RPR, HIV, chlamydia and gonorrhea are negative
• Diagnosis: Lichen Planus
• Treatment: Triamcinolone 0.1% ointment
• Follow-up–Pt returned to clinic 6 weeks later for
unrelated reasons and symptoms had improved both subjectively and objectively
Notes
• Lichen planus presenting at STI clinics often involves the genital area as patients are concerned about an STI
• Careful inspection of the entire body and especially the buccal mucosa may be helpful in establishing the diagnosis
• Topical steroids are often used, but resolution of symptoms is usually slow
Disclaimer
• Copyright all clinical photos: –Dr. Kees Rietmeijer, STD Control Program,
Denver Public Health Department
• Individual slides can be used for educational purposes with reference to source and/or inclusion of the DMHC logo
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