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Dermatology (Expert Forum)
Chronicity
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
Chronicity
by Chronicity, Aug 11, 2007 02:39PM
Doc,
For about two years now, I have had some redness at the Glans and around the meatus and sometimes a red ring around the pulled back foreskin. It won't go away and I am losing my patience. It's almost always red, splotchy, and it fulctuates sometimes more pronounced than others, but never fully gone. Other than some itching and stinging at times at the tip, there are no symptoms to speak of. The history goes like this: It started about six weeks after one episode of unprotected oral sex. I have been tested and retested and all testable STD's have come back negative on more than one occation. Finally, after some coaxing, I convinced a local doctor to do a biopsy which came back as "lichen planus" also possiblity of "lichenoid reaction vs fixed drug eruption" was there too. I was on a low potency steroid but it stung my urethra so I stopped. Then onto protopic for about 10 days without any noticable change, so that was DC'd as well. One last piece of the puzzle, and on to my question. When I retract my foreskin, on the exposed underside only, there are a few small white dots in a very localized area. Sort of litle white heads or "chicken skin". They are small and have not changed in size. Because of the latter, I fear having sex with my partner. I am scared of HPV.
Question: Does this sound like lichen planus? If so, is there any association to HPV? What are the treatments for a condition such as this? Will this EVER go away?
Thanks in advance. I am set to see a derm in about six weeks, but in the meantime, I was hoping for some information as I am growing very inpatient.
For about two years now, I have had some redness at the Glans and around the meatus and sometimes a red ring around the pulled back foreskin. It won't go away and I am losing my patience. It's almost always red, splotchy, and it fulctuates sometimes more pronounced than others, but never fully gone. Other than some itching and stinging at times at the tip, there are no symptoms to speak of. The history goes like this: It started about six weeks after one episode of unprotected oral sex. I have been tested and retested and all testable STD's have come back negative on more than one occation. Finally, after some coaxing, I convinced a local doctor to do a biopsy which came back as "lichen planus" also possiblity of "lichenoid reaction vs fixed drug eruption" was there too. I was on a low potency steroid but it stung my urethra so I stopped. Then onto protopic for about 10 days without any noticable change, so that was DC'd as well. One last piece of the puzzle, and on to my question. When I retract my foreskin, on the exposed underside only, there are a few small white dots in a very localized area. Sort of litle white heads or "chicken skin". They are small and have not changed in size. Because of the latter, I fear having sex with my partner. I am scared of HPV.
Question: Does this sound like lichen planus? If so, is there any association to HPV? What are the treatments for a condition such as this? Will this EVER go away?
Thanks in advance. I am set to see a derm in about six weeks, but in the meantime, I was hoping for some information as I am growing very inpatient.
Doctor's Answer
by Alan Rockoff, MD, Aug 13, 2007 08:34PM
, Aug 13, 2007 08:34PM
To: Chronicity
My best guess is that you have nothing wrong with you at all. Because of the episode of oral sex, you're looking at the penis far too closely, getting more and more tests that are clarifying nothing and making you more anxious over nothing. Biopsy results are only useful to the extent that they correlate with the clinical picture, and your description does not sound like lichen planus. Even if it is that condition, lichen planus is not an STD so that you have no reason to refrain from sex. The little whiteheads belong there.
Bottom line: get yourself examined to confirm what I've suggested. Then get the counseling you need to get on with your life.
Take care and good luck.
Dr. Rockoff
Bottom line: get yourself examined to confirm what I've suggested. Then get the counseling you need to get on with your life.
Take care and good luck.
Dr. Rockoff
