Abstract
A 53-year-old black woman was referred complaining of "lip infection" 4 months ago. After medical consultation she was diagnosed as having a stress injury. Anamnesis revealed systemic arterial hypertension. Extraoral examination showed swollen resected lower lip, painful ulcers covered by crusts and pseudomembrane throughout lower lip, and periodic pulsatile pain. Intraoral examination was normal. Diagnostic hypotheses were exfoliative cheilitis and actinic prurigo. Treatment consisted of local hydration with dexpanthenol cream and ketoconazole, betamethasone, and neomycin topical cream. After 15 days, there was significant clinical improvement, but erythematous regions remained. The medication was maintained for another 15 days without complete resolution. Final clinical diagnosis was actinic prurigo of the lip. Actinic prurigo is an idiopathic photodermatosis that affects skin exposed to sunlight and labial and conjunctival mucosa. It more often affects young women and presents clinically as pruritic lower lip cheilitis that normally does not respond to conventional therapy. A 53-year-old black woman was referred complaining of "lip infection" 4 months ago. After medical consultation she was diagnosed as having a stress injury. Anamnesis revealed systemic arterial hypertension. Extraoral examination showed swollen resected lower lip, painful ulcers covered by crusts and pseudomembrane throughout lower lip, and periodic pulsatile pain. Intraoral examination was normal. Diagnostic hypotheses were exfoliative cheilitis and actinic prurigo. Treatment consisted of local hydration with dexpanthenol cream and ketoconazole, betamethasone, and neomycin topical cream. After 15 days, there was significant clinical improvement, but erythematous regions remained. The medication was maintained for another 15 days without complete resolution. Final clinical diagnosis was actinic prurigo of the lip. Actinic prurigo is an idiopathic photodermatosis that affects skin exposed to sunlight and labial and conjunctival mucosa. It more often affects young women and presents clinically as pruritic lower lip cheilitis that normally does not respond to conventional therapy.
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