Lichen Planus Specialist in London

Lichen Planus of the Penis

Overview

Penile lichen planus (LP) is an inflammatory immune-mediated skin condition that may affect the glans, shaft, or foreskin. It can occur alone or alongside skin, oral, or nail lichen planus.

It is not sexually transmitted.

 

Causes & Triggers

Lichen planus is believed to be a T-cell–mediated autoimmune disorder.

Potential triggers include:

• Certain medications (e.g., antihypertensives, NSAIDs)

• Viral infections (notably hepatitis C)

• Psychological stress

• Contact reactions (rare)

 

Symptoms & Clinical Features

Symptoms vary depending on subtype:

-Classic Lichen Planus

• Purple or violaceous flat-topped papules

• Fine white lines (Wickham striae)

• Itching or mild discomfort

-Erosive Lichen Planus

• Painful red erosions

• Raw or ulcerated areas

• Burning sensation

-Annular lichen planus

Lesions may affect:

• Glans penis

• Penile shaft

• Foreskin

Other body sites (mouth, wrists, ankles) may also be involved.

 

Investigations

-Clinical Examination

Assessment of genital and extra-genital involvement.

-Skin Biopsy

Recommended when:

• Diagnosis uncertain

• Erosive or persistent lesions

• Malignancy suspected

Typical findings:

• Interface dermatitis

• “Saw-tooth” rete ridges

• Band-like lymphocytic infiltrate

-Additional Testing

• Hepatitis C screening (if risk factors present)

• Medication review

 

Associated Conditions

• Oral lichen planus

• Nail changes (ridging, thinning)

• Autoimmune diseases

• Rare association with hepatitis C

 

Complications & Risks

• Chronic pain

• Scarring

• Phimosis (if foreskin involved)

• Sexual dysfunction

• Secondary infection

• Rare malignant transformation in chronic erosive disease

Ongoing monitoring is recommended for erosive forms.

 

Treatment Options

-First-Line

• Medium to high-potency topical corticosteroids

-Second-Line

• Topical tacrolimus or pimecrolimus

• Short course oral steroids (severe erosive disease)

-Refractory Cases

• Systemic immunomodulators (methotrexate, ciclosporin)

• Specialist dermatology referral

-General Care

• Avoid irritants

• Gentle hygiene

• Manage associated stressors

• Review medications that may trigger disease

 

Monitoring & Follow-Up

• Initial review at 2–3 months

• Long-term follow-up for erosive disease

• Biopsy if lesion changes or fails to respond

 

When to Seek Urgent Care

• Persistent non-healing ulcer

• Severe pain

• Bleeding lesions

• Rapid changes in lesion appearance

 

Frequently Asked Questions

1. Is lichen planus infectious?
No.

 

2. Will it spread to my partner?
No.

 

3. Is it permanent?
It may resolve spontaneously or become chronic. Some patients experience remissions and flare-ups.

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Book a consultation

If you have persistent genital skin symptoms, you can book a consultation with Dr Bryan McDonald for an expert, discreet assessment and treatment plan.​