Case report | Volume 3, Article 141, 29 Jul 2020 | 10.11604/pamj-cm.2020.3.141.24310

Penile lichen planus recognized by dermoscopy: a case report

Radia Chakiri

Corresponding author: Radia Chakiri, Department of Dermatology, Faculty of Medicine and Pharmacy, University Ibn Zohr, Agadir, Morocco

Received: 14 Jun 2020 - Accepted: 24 Jul 2020 - Published: 29 Jul 2020

Domain: Dermatology

Keywords: Lichen planus, dermoscopy, penis

©Radia Chakiri et al PAMJ - Clinical Medicine (ISSN: 2707-2797). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Radia Chakiri et al . Penile lichen planus recognized by dermoscopy: a case report. PAMJ - Clinical Medicine. 2020;3:141. [doi: 10.11604/pamj-cm.2020.3.141.24310]

Available online at: https://www.clinical-medicine.panafrican-med-journal.com/content/article/3/141/full

Home | Volume 3 | Article number 141

Case report

Penile lichen planus recognized by dermoscopy: a case report

Penile lichen planus recognized by dermoscopy: a case report

Radia Chakiri1,&

 

1Department of Dermatology, Faculty of Medicine and Pharmacy, University Ibn Zohr, Agadir, Morocco

 

 

&Corresponding author
Radia Chakiri, Department of Dermatology, Faculty of Medicine and Pharmacy, University Ibn Zohr, Agadir, Morocco

 

 

Abstract

Lichen planus is a chronic inflammatory pruritic disease affecting skin, mucous membranes, hair follicles and nails. Dermoscopy have potentially improved the diagnosis of skin diseases by defining specific patterns. We report a case of 34 year-old man with penile lichen planus diagnosed by dermoscopy.

 

 

Introduction    Down

Lichen planus is a common inflammatory disease affecting the skin, the mucous membranes, the genitalia, the nails and the scalp [1]. Lichen planus affects 0.5% to 1% of the general population with adults in the third-sixth decade of life forming the most commonly affected age group [2]. The etiology of lichen planus is unknown since the ethiopathogenesis seems complex, and involvement of genetic, environmental and lifestyle factors have also been suggested. However, immunopathological pathogenesis with T lymphocytes directed against basal keratinocytes is reported [3]. Dermoscopy allows the visualization of structures located in the epidermis, dermo-epidermal junction and papillary dermis that cannot be seen with naked eye [4]. In this report we represent a case of penile lichen planus recognized by dermoscopy.

 

 

Patient and observation Up    Down

A 34 year-old man visited our department for evaluation of four month, mildly pruritic lesions on the penis. Clinical examination revealed violaceus, flat-topped papules on the penile shaft Figure 1. There was no evidence of skin or mucosal involvement and no nail changes on physical examination. The lesions were studied with Dermoscope (Dermlite DL4) revealing yellow dots and reticular whitish structures that correspond to Wickham striae and dots vessels Figure 2. The diagnosis of lichen planus (LP) was considered after clinical and dermoscopic correlation. The patient was started on mild topical steroid to the affected areas for 6 weeks with symptoms improvement.

 

 

Discussion Up    Down

Lichen planus is a chronic muco-cutaneous inflammatory disease of unknow origin. Various potential triggers, for example, viral or bacterial antigens, metal ions, drugs or physical factors, could initiate this autoimmune process [5]. Many variants of cutaneous lichen planus have been described. The annular variant is the most common form of the LP on the glans penis. However lichen planus on the penis can present as the characteristic violaceous, flat topped papules as in our case, or as an erosive, bullous, or atrophic variant [6]. Dermoscopy is a fascinating bridge between clinical and histological examination that has become a key tool for the evaluation of pigmented and nonpigmented skin tumors because of its ability to reveal findings not visible to naked eye [7,8]. Besides this classic application, it is gaining appreciation in areas other than dermato-oncology, especially inflammatory dermatology (inflammoscopy) [7,8]. In lichen planus, dermoscopy findings consist of polymorphic pearly whitish structures, known as Wickham striae (WS). Several patterns of WS have been described including circular, reticular, radial linear, globular, perpendicular and veil-like structureless forms [9]. Other findings include the following: dotted, globular, and/or linear vessels, mainly detectable at the periphery of the lesion and less commonly showing a perifollicular or diffuse arrangement; white/yellow dots; and pigmented structures (dots, globules, and/or reticular or cloud-like areas) [10].

 

 

Conclusion Up    Down

In our knowledge we report the first case in the literature witch highlights the importance of dermoscopy for the diagnosis of penile LP by showing yellow dots and reticular whitish structures and vessels dots.

 

 

Competing interests Up    Down

The authors declare no competing interest.

 

 

Authors' contributions Up    Down

All the authors have read and agreed to the final manuscript.

 

 

Figures Up    Down

Figure 1: violaceus, flat-topped papules on the penile shaft

Figure 2: dermoscopic features of penile lichen planus: reticular whitish structures (green triangles), dots vessels (red circle), yellow dots (black arrows)

 

 

References Up    Down

  1. Chrysoula Papageorgiou, Zoe Apalla, Elizabeth Lazaridou, Elena Sotiriou, Efstratios Vakirlis et al. Atypical case of lichen planus recognized by dermoscopy. Dermatol Pract Concept. 2016;6(4):9. PubMed | Google Scholar

  2. Antana Khurana, Sidarth Tandon, Yogesh S.Marfatia, Nina Madnani. genital lichen planus, underecongnized entitity. Indian J Sex Transm Dis AIDS. 2019 Jul-Dec; 40(2):105-112. PubMed | Google Scholar

  3. Eliana M Minicucci, Silke AT Weber, Hamilton O Stolf, Daniel A Ribeiro. Oro-genital lichen planus: Report of two cases. Maturitas. 2008 Feb 20;59(2):201-5. PubMed | Google Scholar

  4. Russo T, Piccolo V, Lallas A, Argenziano G. Recent advances in dermoscopy. F1000Res. 2016;5. PubMed | Google Scholar

  5. Alessandro Borghi, Annarosa Virgili, Monica Corazza. Dermoscopy of Inflammatory Genital Diseases: Practical Insights. Dermatol Clin. 2018 Oct;36(4):451-461. PubMed | Google Scholar

  6. Christina N Kraus, Janellen Smith. The many faces of penile lichen planus. Int J Dermatol. 2019 Dec;58(12):1460-1461. PubMed

  7. Errichetti E, Stinco G. Dermoscopy in general dermatology: a practical overview. Dermatol Ther (Heidelb). 2016;6(4):471-507. PubMed | Google Scholar

  8. Errichetti E, Stinco G. The practical usefulness of dermoscopy in general der-matology. G Ital Dermatol Venereol. 2015;150(5):533-546. PubMed | Google Scholar

  9. Tan C, Min ZS, Xue Y, Zhu WY. Spectrum of dermoscopic patterns in lichen planus: a case series from China. J Cutan Med Surg. 2014:18(1):28-32. PubMed | Google Scholar

  10. Paula Friedman, Emilia Cohen Sabban, Carolina Marcucci, Rosario Peralta, Horacio Cabo. Dermoscopic findings in different clinical variants of lichen planus. Is dermoscopy useful. Dermatol Pract Concept. 2015;5(4):13. PubMed | Google Scholar

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case report

Penile lichen planus recognized by dermoscopy: a case report

Case report

Penile lichen planus recognized by dermoscopy: a case report

Case report

Penile lichen planus recognized by dermoscopy: a case report

Volume 4 (Sep - Dec 2020)
This article authors
On Pubmed
On Google Scholar
Citation [Download]
EndNote
Reference Manager
Zotero
BibTex
ProCite

Navigate this article
Key words

Lichen planus

Dermoscopy

Penis

Article metrics
PlumX Metrics
Penile lichen planus recognized by dermoscopy: a case report