Oral and Penile Lichen Planus

[WorriedSick1989]

Hey everyone. This has been on my mind for awhile now as I thought I got an STI from a promiscuous girl around Christmas time two months ago, but now I'm thinking otherwise since I was negative for all STIs. I have white patches on the back part of my tongue and there seems to be some sores on my tongue and around the mucosa. These have been there for the past 2 months around since the time I was with that girl.

I have also developed a purple colored ring around the head of my penis and the skin looks really wrinkled around the glans. It also gets pretty itchy under the glans and sometimes gets pretty red. I`m not really sure what to make of this but the only thing that remotely compares to my symptoms is Lichen Planus, but I`m not entirely sure if it`s possible to get it orally and on the penis as well.

I had myself examined by a few doctors because I was extremely worried about this and I was told that it looked normal by each one. I got referred to a urologist just to make sure because my penis didn`t look like this before. I was put on a steroid cream by a walk-in physician when the symptoms first began two months ago, and I used the cream for about a month straight because a second doctor told me to keep putting on the cream even though it wasn`t really doing anything.

I hope the steroid cream didn`t change the color of my penis for good, because I heard you should be using it on sensitive areas consistently for more than 2 weeks at a time. So needless to say I stopped using the cream for the past month and my penis stayed the same as before.

I had something that seems like sebaceous prominence on the shaft as well, which I panicked and thought were warts from that girl I was with. They sometimes feel itchy and irritated but it`s not really a concern for me right now.

I`ve been working 7 days a week for a few months now because I am a student so I`m figuring this may have something to do with my stress level. If anybody has any advice for me let me know, but what I`m really wondering is if Lichen Planus can affect multiple areas in the body such as the tongue and penis. I don`t have any rashes on my legs or anything like that, just these two areas.

All feedback is appreciated! Thank you.

[johnny1725]

My symptoms sound similar to yours except for the fact that nothing is wrong inside my mouth.  Did you ever figure out what is was?  If so, were you able to treat it and how?  Please let me know.  Thanks

[WorriedSick1989]

Thank you very much for following up with me Dr. Kaur. It is much appreciated.

I am now at 2.5 months of dealing with the irritation and symptoms and it does not seem to be improving. I am seeing a urologist on Monday to determine what the issue is. I really hope he does not brush me off and takes my situation seriously. I hope I don`t get another one of those ``it`s all in your head`` psychological diagnoses that are really not helpful and extremely frustrating to deal with. I will ask him if we can perform that fungal test you suggested because all of my symptoms are not typical of any STIs that I know of.

In summary, these are my daily and persistent symptoms of 2.5 months that began after my unprotected vaginal sex exposure;

- White, patchy tongue. Sometimes some sores around the inside of my mouth.
- Base of glans red-purple in colour. Wrinkled with vertical lines or cuts all across.
- Itchiness and redness under glans. Especially after sex and masturbation.
- Irritation on the underside of penis with very small skin colored bumps.

I`m not sure if all these symptoms are typical of a fungal infection but I was negative for chlamydia, gonorrhea, syphilis, Hep C and HIV. I have not had a herpetic lesion of any sort in the past two months or any type of indicator that I have genital herpes. I was concerned that this may have been caused by a type of HPV but the bumps on the underside of my penis really don`t seem like warts and three different doctors also agreed. The bumps are sometimes irritated and itchy whereas warts should not be.

If anybody has any other information or personal experiences please don`t be shy to share. Many thanks.

[Bhupinder Kaur, MD]

Hello,
Since the symptoms have been persisting for quite some time and to completely rule out any fungal infection which can affect both mouth and genitalia. I suggest you to get a KOH examination of the skin scrapings of the scalp done. It is specific for fungal infections. Fungal culture will also help you and for confirmed diagnosis you can get a skin biopsy done as well.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[WorriedSick1989]

Hey Dr. Kaur,

I have been experiencing the exact same symptoms as I first mentioned at the beginning of this thread. My penis is red and itchy around the head and the skin looks inflamed and a purple-red color around the bottom. I also have white patches on the back of my tongue. I was panicking that this was herpes, but I got examined 6 times by 3 different doctors to make sure. All STI tests are negative.

Each doctor told me that it was not an STI and not to worry about it.. But they did not treat my problems. I am still itchy around the head of my penis, shaft and sometimes testicles and thighs but I never had any herpetic lesions of any sort. I have been dealing with this problem but it is really uncomfortable at work sitting at my desk.

My doctor said it might be psychological too because the girl I was with just before this occurred was quite promiscuous and I was worried about it. But I am kind of at peace with what I did now and the symptoms still persist.

I really want this to clear up. I cannot masturbate or have sex anymore because my penis gets so sore and red. Really depressing. I think that it is thrush personally because it is affecting my tongue and penis so I will ask the urologist I am seeing at the end of the month about anti-fungals or something.

Any other suggestions doctor? I gargle salt water 2 times a day which helps with my tongue but the penile irritation still persists.

[Bhupinder Kaur, MD]

Hello,
Yes lichen planus can affect the mucus membrane of the mouth as well as genitalia and your symptoms can be typically of lichen planus. Lichen planus is an inflammatory disease that affects the skin and the oral mucosa, and presents itself in the form of papules(flat spots) or rashes. It is an itchy papular eruption characterized by its violaceous color.

Treatment is available only on prescription and consists mainly of steroids, retinoids, hydroquinone and phototherapy. My sincere advice would be to consult a dermatologist to get the diagnosis confirmed. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.