Annular lichen planus of the glans explained

The glans may develop a smooth ring or curved patch with a red, dusky or violaceous edge; fine pale lines can sometimes be visible on its surface. Genital lichen planus may itch, burn or feel sore, but it can also cause little discomfort. The clinician may inspect the rest of the skin, mouth, scalp and nails because lichen planus can affect more than one site. Fungal infection, dermatitis, psoriasis, medication reactions and sexually transmitted infections can resemble it, so diagnosis should not be based on a photograph or symptom alone. A biopsy or infection testing may be considered when findings are unclear.

Wash gently with lukewarm water or a fragrance-free cleanser, pat the area dry and avoid perfumed products, antiseptics and vigorous rubbing. Pause any product that clearly aggravates the skin. A prescribed topical corticosteroid can reduce inflammation, but genital skin absorbs medicine readily, so use only the amount, frequency and duration directed by your clinician. Persistent or extensive disease may call for a different topical medicine or systemic treatment under specialist supervision. If sexual contact causes friction or soreness, allowing the skin to settle and using a simple lubricant when comfortable may reduce irritation.

Arrange an examination for a persistent or recurring patch on the glans, especially when its cause has not been confirmed. Prompt review is warranted for an open sore, bleeding, increasing pain, pus, fever, difficulty passing urine, a tight foreskin that becomes stuck, or rapidly spreading swelling or redness. New blisters or discharge after sexual contact also need appropriate infection assessment. Return to your dermatologist if a treated area fails to settle, becomes thickened or changes its appearance.

You may want to ask whether infection testing or biopsy is needed, precisely where and how thinly to apply medication, and which cleansers or lubricants are compatible with treatment. Clarify whether sexual partners need any assessment; lichen planus itself is not sexually transmitted, although a look-alike infection may require a different plan.