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