Cheilitis Research Articles

Treatment of chronic lip fissures with carbon dioxide laser

Resurfacing of cutaneous tissue with carbon dioxide laser increases the amount and quality of collagen and elastin subepithelially. We used this technique to ablate 12 chronic lip fissures in one woman and 10 men. Five patients’ fissures had persisted for durations ranging from several months to seven years; the other six had fissures that split between one and five times annually, and took weeks or months to heal. Ten fissures had re-epithelialised completely six weeks postoperatively, while in two cases the treatment was repeated. At mean long-term follow-up of 70 months (range 44–93) of 11 cases, eight had had no recurrence. One patient, whose fissure had healed at three months was lost to follow-up; one fissure had not improved; one had recurred less severely; and one had split only once, then healed quickly and not recur. Only one patient had postoperative discomfort that required analgesia, and one had a mildly raised scar. This small series shows that this is a successful, safe technique with low morbidity, however, the technology is not always readily available.

Trumpet Cheilitis in a Novice Musician

Trumpet Cheilitis in a Novice Musician

Factitious cheilitis: a case report

IntroductionFactitious cheilitis is a chronic condition characterized by crusting and ulceration that is probably secondary to chewing and sucking of the lips. Atopy, actinic damage, exfoliative cheilitis, cheilitis granulomatosa or glandularis, contact dermatitis, photosensitivity reactions and neoplasia should be considered in the differential diagnosis of crusted and ulcerated lesions of the lip.Case presentationWe present a 56 year-old female with an ulcerated and crusted lesion on her lower lip. The biopsy showed granulation tissue and associated inflammation but no malignancy. Based on the tissue examination and through clinical evaluation the diagnosis of factitious cheilitis was rendered.ConclusionThorough clinical history, utilization of basic laboratory tests and histopathologic evaluation are required to exclude other diseases and a thoruough psychiatric evaluation and treatment is vital for successful management of these patients.

Granulomatous cheilitis: sustained response to combination of intralesional steroids, metronidazole and minocycline.

Various conservative methods for treatment of labial swelling in patients with granulomatous cheilitis have been attempted, often with only moderate success. We report a case of granulomatous cheilitis who showed excellent sustained response to combination of intralesional steroids, metronidazole and minocycline for initial one month followed by prolonged maintenance treatment with minocycline alone.

Treatment of chronic lip fissures with carbon dioxide laser resurfacing—A long-term follow-up

Introduction: Chronic lip fissures are relatively prevalent lesions that can cause significant discomfort and cosmetic concern, leading patients to seek professional advice. Unfortunately not all cases respond to conservative forms of treatment and whilst surgical excision and cryotherapy have proved to be effective modalities both have their drawbacks.

Cheilitis – the only presentation of photosensitivity

Cheilitis – the only presentation of photosensitivity

Clarinettist's Cheilitis by Allergy to Cane Reed

Clarinettist's Cheilitis by Allergy to Cane Reed

Case Report: Exfoliative Cheilitis Managed with Antidepressant Medication

Exfoliative cheilitis is an unsightly and uncommon, chronic superficial inflammatory disorder that affects the vermilion zone of the lips. This case report describes the presentation of exfoliative cheilitis in a young man, and his subsequent management with antidepressant medication. The differential diagnosis of chronic exfoliative cheilitis is outlined.

KENDALA DALAM PENATALAKSANAAN KEILITIS EKSFOLIATIF (Laporan Kasus)

Exfoliative cheilitis is a rare chronic superficial inflammation disorder which affect vermilion border of the lips, especially lower lip. This disorder mostly happens in woman. The characteristics of this disease are a large amount production and desquamation of the keratin layers. The etiology and pathogenesis of exfoliative cheilitis is unknown. Diagnosis of exfoliative cheilitis can only be established if the conditions od the disease couldn’t be connected to others factors. Exfoliative cheilitis is very resistant to many treatment modalities, which gave a difficulty to determining a therapy with an optimum result. Topical steroid was the most effective therapy for the disease. Antifungal therapy can be used only if there is a secondarily infection caused by Candida . This case report is about an exfoliative cheilitis on 42 years-old women with unknown etiology backgrounds. On intra-oral examination we found out that there were several focus of infections that can delay the healing processes. The patient’s conditions were resolved after a few month of topical steroid therapy, a month of antifungal therapy and management of the focus of infections. An exact diagnosis, an appropriate management, good corporation between sections which are related to patient condition and patient corporation are very important on the healing of exfoliative cheilitis.

Down syndrome: lip lesions (angular stomatitis and fissures) and Candida albicans.

The incidence of angular cheilitis (angular stomatitis, perleche, commissural fissures) appears to be increased in people with Down syndrome (DS). Lip fissures are also (in our clinical impression) a fairly regular feature, yet this is scarcely mentioned in the literature. To establish the incidence of angular cheilitis and lip fissures in a substantial group of patients with DS and to examine the relationship with Candida albicans. The prevalence of orofacial soft tissue lesions was investigated in a group of 77 DS patients. Swabs were taken from lip lesions, palate and tongue and inoculated on Sabouraud's agar discs for the isolation of C. albicans, identified with commercially available kits. Lip fissures were seen in at least one-quarter of DS patients. Angular cheilitis was also found in a similar percentage. C. albicans was isolated from a substantial proportion of lesions tested, and was present more frequently than in those without lip lesions, but it is uncertain whether this represents cause or effect.

Oral manifestations in HIV‐positive adults from Northern Thailand

Eighty-seven HIV-infected patients in a provincial hospital in Northern Thailand were examined for oral manifestations of HIV disease and AIDS. The median age was 31.3 years. Seventy-four of the patients were women, 13 were men. 96.6% had a history of heterosexual transmission. Sixty-one patients were CDC-category A, 20 were category B and 6 were category C (AIDS). Thirty-eight percent of the patients revealed oral lesions; 23% had one oral lesion and 13.8% had two oral lesions. Common lesions were oral candidiasis (10.3% pseudomembranous candidiasis, 6.9% erythematous candidiasis and 3.4% both forms), oral hairy leukoplakia (11.5%) and exfoliative cheilitis (6.9%). Gingival linear erythema was seen in 8% of the patients; periodontal lesions and necrotising ulcerative gingivitis were not observed. Men were more commonly affected by oral manifestations than women (P < 0.004). The spectrum of oral lesions is comparable to other studies from the region, although most of these reported more men than women. Also, the degree of immunosuppression was more marked (AIDS).

Report of two cases of exfoliative chelitis and brief literature review

Report of two cases of exfoliative chelitis and brief literature review

Exfoliative Cheilitis (EC) in AIDS: Association with Candida infection

Exfoliative Cheilitis (EC) in AIDS: Association with Candida infection

Oral manifestations of HIV infection by gender and transmission category in Mexico City.

A cross-sectional analysis was conducted in Mexico City from September 1989 to March 1996, to determine the prevalence of HIV-related oral manifestations by gender and route of HIV transmission. The diagnosis of HIV-associated oral lesions was based on preestablished criteria. For the statistical analysis chi-squared and Fisher's exact tests were used where appropriate. Odds ratios were calculated as estimates of the relative risks. Control of confounding factors was performed by logistic regression models. Oral lesions were present in 75% of 436 HIV+ patients. Hairy leukoplakia, erythematous and pseudomembranous candidosis, angular cheilitis and oral ulcers were frequently found. Patients who contracted HIV through blood transfusion were more likely to present erythematous candidosis (P=0.005) than subjects who acquired HIV through sexual transmission. Oral ulcers were seen only in men (P=0.02) and in individuals who contracted HIV through sexual transmission (P=0.02). This study brings valuable data in regard to differences in the type and prevalence of HIV-related oral lesions by gender and the risk categories analysed, particularly blood transfusion.

Diseases of the lips

The vermilion of the lips was conceptualized by Jean Darier as the semi-mucosa. The anatomy of the lips is transitional from skin to mucous membrane. This article emphasizes inflammatory diseases of the lips known as cheilitis. Angular cheilitis is a reactive process with several possible causes, including infections, mechanical, nutritional deficiency, and various dermatoses. Contact cheilitis may be caused by a primary irritant or a delayed hypersensitivity allergic reaction to contactants. Plasma cell cheilitis is a reactive periorificial mucositis. Exfoliative cheilitis is also a reactive process, probably secondary to factitious activity of the patient. Cheilitis glandularis is a chronic inflammatory disorder of the labial salivary glands and their ducts. There are three forms: simple, superficial suppurative, and deep suppurative. A premalignant potential is present in cheilitis glandularis. Cheilitis granulomatosa is one manifestation of orofacial granulomatosis. The granulomatous conditions of Melkersson-Rosenthal syndrome, sarcoidosis, and Crohn's disease may be associated with cheilitis granulomatosa or it may stand alone as Miescher's cheilitis. Actinic cheilitis is another premalignant form of cheilitis that is amenable to a variety of therapeutic modalities.

Median lip fissures and their management

Median lip fissures are an uncommon condition and usually give rise to pain and episodes of bleeding. We report three cases of median lip fissures which were treated by surgical excision.

Exfoliative cheilitis (EC) in AIDS: association with Candida infection.

Forty-seven of 165 patients with AIDS (28.5%) showed exfoliative cheilitis (EC), predominantly of the lower lip (n = 37). Histologically, hyphae were revealed in 23 of 47 cases (49%). In 14 of 23 specimens the histological and microbiological findings were in accordance. Smears of the vermilion border revealed Candida albicans in half of the cases (51%); however, combinations with C. krusei, C. tropicalis and C. glabrata were also seen. Twenty of 35 patients given fluconazole either prophylactically or therapeutically showed clinical signs of oral candidiasis. Frequent moistening of the lips may result in infection of the vermilion border with Candida species; consequent desiccation of the lips will lead to scale formation and exfoliation. Smears of the vermilion border of the lower lip of 20 controls with AIDS were positive in four cases. Twenty HIV-negative controls without EC showed negative microbiological results for Candida species. Exfoliative cheilitis may be associated with Candida infection in some cases and may be considered another variant of candidiasis in AIDS patients.

5-ALA Photodynamic Therapy for Actinic Cheilitis

Photodynamic therapy with topical 5-aminolevulinic acid (5-ALA) has been used with success to treat cutaneous premalignant and malignant conditions.

Median lip fissure.

Forty-two cases of median lip fissures are reported. The majority of these had earlier been treated conservatively without healing. All cases were corrected by surgery, the first 10 by excision only, the remaining 32 by excision combined with Z-plasty. In the first group, one total and one partial relapse occurred; in the second group all patients healed uneventfully. Pedigrees were obtained and indicated that a hereditary component in the cause exists. The location of and the resistance to conservative treatment may suggest that these lesions that seem to be due to a weakness in the lip may be very discreet manifestations of the cleft, which, in more severe cases, was classified as no. 30 by Tessier.

Exfoliative cheilitis

Exfoliative cheilitis is an uncommon condition affecting the vermilion zone of the upper, lower or both lips. It is characterized by the continuous production and desquamation of unsightly, thick scales of keratin; when removed, these leave a normal appearing lip beneath. The etiology is unknown, although some cases may be factitious. Attempts at treatment by a wide variety of agents and techniques have been unsuccessful. Three patients with this disease are reported and its relationship to factitious cheilitis and candidal cheilitis is discussed.