Brief Answer:
If not better after you have used Locoid cream for 1 month, then do biopsy

Detailed Answer:
Hello,

Thank you for using HCM to post your question.

I read it carefully and I saw your pictures.

From what you are telling me, I agree with your doctors approach.

It can be a 1) lichen, 2)not much possible to be psoriasis unless you have other lesions on your body, 3) it can be skin cancer if its not getting better.

So, my recommendation and answer to your question is that if after applying the steroid cream for one month, it hasn't gotten better, then you should go and consider doing the biopsy to rule out skin cancer.
I must say that it is not a very much typical place for a cancer, but you never know with cancers, better be sure to rule them out or diagnose as much early as possible.

Hope this is helpful.
Let me know if you have other questions or concerns.
Otherwise please close and rate the answer.

Regards,
Dr. Papaqako

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Brief Answer:
Not much likely but if not better the possibility its still there.

Detailed Answer:
Hello dear,

Thank you for the follow-up question.
I appologise for the late reply.

That is a very good question.
No, if it was a cancer it wont spread like that. So thats why we rule out other things first and wait to see the progression.

-- If it was lichen or psoriatic patch it would be better after using the steroid for one month.
-- It may be a fungal infection, but it would be itchy. If you want to try using an antifungal cream, try using lamisil or ketoconazole for 2 weeks. It doesn't have side effects and it would help for psoriases as well.
-- Are you sure it wasn't there before when you saw the first one? Sometimes we may miss lesions. But its reassuring if you are sure it wasn't there because gives us a piece of mind that it is less likely to be cancer.
-- If you are sexually active, would be good to rule out any sexually transmitted diseases also.
-- There is not much else to rule out. Then again, not saying it can be cancer, don't stress over the thought of it. But it is one thing to keep in the back of your mind that needs to rule out. Doing a biopsy hurts much less, then the risk (even if very small) of having cancer. And it will also rule out other diagnoses.

These were my thoughts. Let me know what you think, and feel free to ask any more questions if needed.

Regards,
Dr.Papaqako

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Brief Answer:
Happy to have been of help

Detailed Answer:
Glad to be of help.

Follow up with me on the result if you wish.

Please don't forget to close the question

Kind regards,

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