Purple, Pruritic, Polygonal Papules in a Boy
J.A. Schneider, DO Medical Director, Adolescent Medicine Mobile Health Outreach
St. Vincent Hospital - Jacksonville, FL CAPT, MC, USN (Ret)
Asst. Professor, Division of Adolescent Medicine, University of Florida (Ret)
Arthur Itis u 10-year-old male with a past hx of nummular
eczema presents to the clinic with a two week history of a rash that did not respond to 1% HC cream. This rash began as slightly erythematous PLANAR (flat topped) PAPULES that became increasingly POLYGONAL in configuration and coalesced into larger violacious PLAQUES that were PURPLE and PRURITIC and even involved the PENIS.
Overview of Arthur…
Purple, polygonal papules and plagues
Close-up of purple, polygonal papules and plaques
One picture says it all…
•Purple
•Polygonal
•Planar
•Papules
•Plaques
that are also
•Pruritic
and also...
on very close inspection are Penile in location
Another patient with a white , lacey pattern on the buccal mucosa that is often found in….
Answer: Lichen Planus “P”s of Lichen Planus üPURPLE üPOLYGONAL üPRURITIC üPLANAR üPAPULES üPLAQUES üPENILE
Agents That Cause Lichen Planus-like Eruptions
uArsenic uGold uPAS uIsoniazid uQuinidine
uStreptomycin uDiabinase uPhenothiazides uSalts in color film
Treatment uRemove offending agent if known uTopical steroids uAtarax
References l Shai A, Halevy S Lichen planus and lichen
planus-like eruptions: pathogenesis and associated diseases. Int J Dermatol (United States), Jun 1992, 31(6) p379-84
l Kanwar AJ, Handa S, Ghosh S, et al. Lichen planus in childhood: a report of 17 patients. Pediatr Dermatol (United States), Dec 1991, 8(4) p288-91
References • Boyd AS, Neldner KH Lichen planus J Am
Acad Dermatol (United States), Oct 1991, 25(4) p593-619
• Mokni M, Rybojad M, Puppin D Jr, et al. Lichen planus and hepatitis C virus. J Am Acad Dermatol (United States), May 1991, 24(5 Pt 1) p792