What should you know about reticular and erosive lichen planus?

Lichen planus is an inflammatory condition that can affect skin and moist linings such as the mouth or genitals. Reticular disease produces fine white, branching or net-like lines, often with little discomfort. Erosive disease produces red, fragile, ulcerated or raw areas that may burn, bleed or hurt with eating, brushing or sexual contact. The patterns can occur together, and a careful examination may be needed to distinguish them from infection, irritation or another inflammatory disorder.

Arrange dermatology or oral-medicine review for persistent patches, recurring ulcers or unexplained skin bumps. Bring a list of medicines and mention mouth, genital, scalp or nail changes. Use gentle, fragrance-free care and avoid picking, smoking, alcohol-based mouthwash and foods that sting erosions. Clinicians may prescribe topical corticosteroids for local inflammation; oral corticosteroid treatment or another approach may be considered when disease is extensive or difficult to control.

Seek prompt care for an erosion that cannot heal, prevents drinking or eating, bleeds repeatedly, becomes increasingly painful or develops pus, swelling or fever. Urgent help is appropriate for dehydration, rapidly spreading swelling, breathing difficulty or severe eye symptoms. A persistent erosive area should be monitored rather than treated repeatedly with over-the-counter products.

Ask which pattern is present, whether a biopsy or medication review is needed, how to apply treatment safely to delicate tissue, how long follow-up should continue, and which changes require earlier review.