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