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March 14, 2012

Reticulated White Lip

JAMA. 2012;307(10):1025-1026. doi:10.1001/jama.2012.283

To the Editor: In the JAMA Clinical Challenge describing the acute onset of reticulated white striae on the lower lip of a 62-year-old woman determined to have a lichenoid drug eruption, the authors suggested the next step was to obtain a skin biopsy and discontinue lisinopril.1 I submit that the correct answer to this exercise is an option that was not provided: discontinue lisinopril. Do nothing else, except this instruction to the patient: “return if the rash worsens or does not resolve in 2 months. See your internist for substitution of another drug for lisinopril.”

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