lichen planus of the penis

Diagnosis: lichen planus of the penis

itchy,flat topped,shiny,mauve papules,polygonal in shape

Clinical Presentation

itchy,flat topped,shiny,mauve papules,polygonal in shape

Clinical History

Submitted by sameh elseiny. Originally posted March 27, 2011.

Treatment

See case discussion.

Differential Diagnosis

• Drug-induced lichenoid eruption • Psoriasis (guttate) • Pityriasis rosea • Secondary syphilis • Eczema • Lichen nitidus • Lichenoid keratosis • Graft-versus-host disease

Key Learnings

• Remember the 6 P's: Pruritic, Purple, Polygonal, Planar (flat-topped), Papules, Plaques • Wickham striae (fine white lines on surface) are pathognomonic — best seen with dermoscopy • Koebner phenomenon: lesions at sites of trauma • Oral LP: most common mucosal form — reticular (lacy white striae) vs. erosive • Erosive oral LP has a small risk of SCC transformation — requires monitoring • Hepatitis C association varies geographically — screening recommended • Histology: interface dermatitis with band-like lymphocytic infiltrate, sawtooth rete ridges, Max Joseph spaces (civatte bodies)

Tags: lichen, planus, the, penis, sameh elseiny