Annular Lichen Planus on Penis Treated with Topical Pimecrolimus

Khalid M. AlGhamdi^*
*Correspondence: Khalid M. AlGhamdi, Department of Dermatology, King Saud University, Saudi Arabia, Email:

Editorial

Lichen Planus (LP) is an idiopathic fiery illness of the skin and mucous layers. Old style LP is described by pruritic, violaceous papules that favor the limits. Annular Lichen Planus (ALP) is a long-perceived clinical variation of lichen planus, however is frequently viewed as remarkable in event. Snowcapped mountain ordinarily includes the male genitalia yet in addition has an inclination for intertriginous regions, for example, the axilla and crotch folds. Distal parts of the limits, and less normally the storage compartment, may likewise be involved. We report the instance of 38 year-old uncircumcised male patient who tended to our center for quite a long time annular sores on the glans penis and corpus penis and whitish straight two-sided and symmetric lines on buccal mucosa with 2 years term. During this period the patient was dealt with a few times with antifungal and corticosteroid drugs without progress. Determination depended on clinical elements and histological assessment. The patient was treated with effective pimecrolimus 1% with critical improvement following 3 weeks. Lichen planus is a cell-intervened safe reaction of obscure beginning, influencing skin, mucous films, scalp and nails. It very well might be found with different illnesses of modified invulnerability, for example, ulcerative colitis, alopecia areata, vitiligo, dermatomyositis, morphea, lichen sclerosis, and myasthenia gravis. The term lichen planus was at first presented by Erasmus Wilson in 1869 to portray the condition that had been recently named leichen ruber by Hebra. Classical LP is described by pruritic, violaceous papules that favor the furthest points. It has various variations in light of the morphology of the sores and the site of contribution [1-4].

A 38-year-elderly person, uncircumcised, weighty smoker was conceded in our center. He denied chronic drug use and sexual openness. Clinically various asymptomatic annular injuries different in size, with marginally raised edge and commonly purple to white in shading and focal part with skin-shading were introduced on glans penis and corpus penis. There was no injury elsewhere on the skin. Whitish direct two-sided and symmetric lines on buccal mucosa were noticed. The principal injury was seemed 2 years before as rosy purple papul which spread incidentally and the focal region was settled. Following a time of a half year the patients saw the progressions on oral mucosa like gentle uneasiness and modified awareness. He was dealt with a few times for Candida balanitis with Fluconazole effective and fundamental without clinical improvement. He was additionally treated with effective corticosteroids for quite a while without clinical improvement. Microscopy and culture flavors were negative for Candida spp. what's more, different microorganisms. Serologies for hepatitis B and C, syphilis, and HIV were negative. Histological assessment of a biopsy example was predictable for Lichen planus. Eipdermal acanthosis with both hyper-orthokeratosis and hypergranulosis were noticed. There was likewise a band-like lymphocytic invade at dermal-epidermal intersection with hydropic degeneration of the basal layer with which apoptotic bodies were seen. Direct resistant fluorescence was negative [5].

Conclusion

Skin pimecrolimus in mix with insusceptible energizer drug (lactofer and colastrum) were recommended, which prompted huge clinical improvement following 3 weeks of treatment. Annular Lichen Planus (ALP) is a long-perceived clinical variation of lichen planus, however is frequently viewed as exceptional in event. High mountain was first announced in writing by Dr. Galloway in 1899 as particular from lichen planus of annular sort. The instrument of beginning of annular sore is at this point unclear; most likely articulations of ICAM-1 and TNF-alpha in the fringe keratinocytes and dermal invaded cells assume significant part. There isn't information for race and orientation inclination in writing. The ejection at first happened as lichen-papules, then, at that point, extended, lastly created annular indications with raised edges and focal clearing. Snow-capped mountain regularly includes the male genitalia yet in addition has a preference for intertriginous regions, for example, the axilla and crotch folds.

Acknowledgement

None.

Conflict of Interest

The authors declare that there is no conflict of interest associated with this manuscript.

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