Cheilitis Research Articles

Exfoliative cheilitis: diagnosis, treatment - a case report

Exfoliative cheilitis: diagnosis, treatment - a case report

Factitious cheilitis presenting as exfoliative cheilitis: A rare case report.

Factitious cheilitis presenting as exfoliative cheilitis: A rare case report.

Exfoliative Cheilitis Associated with Chronic Lip Licking - A Case Report

Exfoliative cheilitis is a troublesome condition of lips which can be caused by different factors. One of them is a parafunctional habit of lip liking. This article describes such a case whose outcome was very successful as the patient was able to control her unrelented habit of moisturizing the lips with her tongue, along with a brief use of moderate potency topical corticosteroids.

Cheilitis: A Diagnostic Algorithm and Review of Underlying Etiologies.

Cheilitis, or inflammation of the lips, is a common reason for dermatologic consultation. The inflammation can include the vermillion lip, vermillion border, and surrounding skin, and can present with an acute or chronic course. There are many etiologies, including irritant and allergic contact dermatitis, atopic cheilitis, actinic cheilitis, infectious etiologies, nutritional deficiencies, drug-induced cheilitis, and rare etiologies, including granulomatous cheilitis, cheilitis glandularis, plasma cell cheilitis, lupus cheilitis, and exfoliative cheilitis. Distinguishing among the various etiologies of cheilitis is clinically difficult, as many causes may produce similar erythema and superficial desquamation of mucosal skin. In addition, patients report dryness, redness, irritation, burning, fissuring, and itch in many of the underlying causes. Thus, the specific etiology of cheilitis is often difficult to diagnose, requiring extensive testing and treatment trials. In this review, we summarize the various types of cheilitis, synthesizing novel cases, clinical presentations, histopathology, epidemiology, and advancements in diagnostic methods and therapeutics. We provide a diagnostic algorithm aimed to assist clinicians in the management of cheilitis.

INTERRELATION RECURRENCE RATE OF CHEILITIS FROM THE LEVELS OF VITAMIN D

Vitamin D deficiency is a widespread problem among carriers, people living in acute lack of sunlight in northern latitude regions, this is the result of low serum concentrations of the vitamin. Chronic lip fissure and meteorological cheilitis are the most common forms of cheilitis among residents of the Far North. The role of vitamin D deficiency has not been studied in patients with these diagnoses. The purpose of the study is to measure the level of vitamin D in the blood serum in patients with chronic lip fissure and meteorological cheilitis, as well as to dynamically study the dependence cases of disease recurrence on the concentration vitamin D. The study was conducted in 79 residents of the Murmansk region for 12 months. Diagnostic results have established that low serum vitamin D concentrations support the recurrence of meteorological cheilitis and chronic cleft lip. The use of vitamin D to maintain a normal level of vitamin in the blood serum improves the regenerative ability of the lip skin, maintains the barrier function of the epithelium, and reduces cheilitis recurrence rate. The study found that in the conditions of the Far North one of the mandatory components of the prevention and pathogenetic therapy of meteorological cheilitis and chronic lip fissure should be vitamin therapy with cholecalciferol preparations.

МЕТОДОЛОГИЧЕСКИЕ ПРИНЦИПЫ ЛЕЧЕНИЯ ХЕЙЛИТОВ НА КРАЙНЕМ СЕВЕРЕ

When studying exogenous factors of the Far North that negatively affect human health, it was established: the impact of not only low temperatures, traumatic aerodynamic conditions, and a deficiency of ultraviolet radiation, but also geomagnetic field tension, microelement shifts in the composition of soil and water, and fluctuations in atmospheric pressure levels. A special role for carrying out therapeutic and diagnostic measures is played by the fact that the entire territory located beyond the Arctic Circle belongs to zones with a significant deficiency of the biologically active part of the solar spectrum of ultraviolet radiation. This leads to disruption of photoperiodicity due to the change of polar day and polar night, disruption of biological rhythms, and a decrease in reserve capabilities for regulating homeostasis. The fact that a person lives in a long-term deficiency of ultraviolet radiation affects all biological processes occurring in the body; it plays a special role in the occurrence and development of some forms of cheilitis. The study involved 37 patients aged 18 to 55 years with a diagnosis of chronic recurrent fissure of the lip, meteorological cheilitis, dry form of exfoliative cheilitis, symptomatic atopic cheilitis. After a thorough history, review of patient medical records, and dental examination, serum vitamin D and E levels were measured in all patients before treatment. The best results in treatment were achieved by prescribing combined ointments based on glucocorticoids and antibacterial/antifungal components in combination with physiotherapeutic procedures.

COMPREHENSIVE MANAGEMENT OF ORAL FRAILTY IN MULTIPLE SYSTEMIC DISEASES GERIATRIC PATIENT

ABSTRACTBackground Oral frailty is an important geriatric syndrome characterized by decreases in oral function that coincides with declines in cognitive and physical function. Objective: The aim of this case report is to describe the comprehensive management of oral frailty in a medically compromised geriatric patient prior to cardiovascular surgery. Case: A 64-year-old male patient complained of pain in swallowing and sore mouth since two days before. He had multiple systemic diseases, including infective endocarditis, acute kidney injury, type II diabetes mellitus, thrombocytopenia, and electrolyte-fluid imbalance. Extra-oral examination showed lymphadenitis, icteric sclera, and dry-exfoliative lips. Intra-oral examination revealed tongue depapillation, frothy saliva, and dry mucosa with poor oral hygiene. The scraped-off white plaque leaving erythematous area was found on the dorsal and ventral tongue, buccal mucosa, and hard palate. Irregular multiple major ulcers, surrounded by erythema, well-demarcated with yellowish concave base, and covered by thick yellowish-green sputum at the soft palate to the uvula. The diagnosis was exfoliative cheilitis, aphthous-like ulcer, acute pseudomembranous candidiasis, and moderate xerostomia. A D-E-N-T-A-L questionnaire was used to evaluate oral frailty, and the cumulative result was seven. Case Management: The patient was treated with 100% petroleum jelly, 0.12% chlorhexidine digluconate mouthwash, and chlorine dioxide-zinc mouthwash three times a day. The oral lesions showed significant improvement after one week of treatment. Conclusion: Appropriate therapy for oral lesions and eliminating the infection could be considered to minimize the long-term effect of oral frailty. The comprehensive management of oral frailty could be beneficial for improving the quality of life. Keywords: Geriatric, Oral frailty, Oral lesion, Systemic disease

Exfoliative Cheilitis in Childhood: A Successful Treatment with Tacrolimus

Exfoliative cheilitis is a hardly diagnosed disease by pediatricians. We have presented this report to draw the attention of cliniciansbecause the child is the youngest patient with complete relief from using tacrolimus ointment in the literature. We present the three-year-old child with scaled, crusted, and sensitive upper and lower lips. He was admitted to different centers from the beginningof the complaints without any relief despite different treatments. The clinicians may encounter exfoliative cheilitis in different agegroups. There are some approaches to management and therapy of the disease. But consensus has not yet occurred on definitivetreatment, especially in childhood.

Prevalence of Lip (Diseases/Disorders/Lesions) among Adult Population Visiting Out-Patient Clinic in Central Punjab.

Aim: To find out the prevalence of various commonly occurring lip anomalies like lip fissures, angular chielitis, lip pits and allergic cheilitis in patients visiting out-patient clinic in central Punjab. Methods: This is a prospective observational study conducted at the diagnostics department of Nishter institute of dentistry, Multan from Feb,2022 to December,2022 for a period of 11 months to determine the relative frequency of various lip anomalies in adult population of central Punjab. Six hundred patients were examined with an age range of 25-35 years in a quite comfortable environment using dental mirror, natural light and surgical gauze. The result was analyzed by using chi-square test in SPSS. Results: The prevalence of lip anomalies in 600 patients was 24.3% among male and female patients. These lesions were more prevalent in patients of 25 to 30 years of age (55.47%) compared to 30-35 years of age (44.52%). Among lip lesions, lip fissures were seen in 7.4% cases, lip pits were 2.6%, allergic chielitis was seen 1.8% and patients with angular chielitis were 12.4%. All lesions showed almost equal distribution among male and female patients seen during the study. Practical Implication: Our study was done in central Punjab region. It highlighted the commonly occurring lesions of lip which could affect the aesthetics of the people as well as has important psychological impact on their daily life. Our study showed the prevalence of lesions and also motivated the people to seek possible treatment of the lesions. It helped a lot to educate affected community and encouraged them to improve their conditions. Conclusion: The results of the study are in accordance with some previous studies although they contradict to some other studies as well. This study has also shown that the lip anomalies are slightly more in females as compared to the males although the statistical difference is not significant. Moreover, the age is not related to the lip anomalies. Keywords: Lip anomalies, Lip fissures, angular chielitis, allergic chielitis, lip pits.

Oral Health and Oral Health-Related Quality of Life in Patients with Primary Sjögren's Syndrome.

Background and Objectives: Oral disorders, frequently observed in patients with primary Sjögren's syndrome, can profoundly affect patients' daily lives and well-being, as oral health represents a fundamental part of general health. Saliva plays an essential part in maintaining and protecting oral health, so the decrease in its quantity and quality leads to chronic oral discomfort alongside a broad spectrum of problems. The objective of the present study was to evaluate the oral health of patients with primary Sjögren's syndrome and establish its effect on the different domains of their oral health-related quality of life (OHRQoL). Materials and Methods: The research was designed as an observational case-control study with prospective data collection. Eighty patients, divided into two groups based on their oral status, participated in the study. All subjects underwent a complete oral examination. The OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14). Results: The most prevalent oral manifestation was exfoliative cheilitis, while 30% of subjects complained of chewing and swallowing difficulties. The OHIP-14 summary score was significantly higher in the patients with oral lesions (26.0 (5.0) vs. 17.0 (4.0), respectively; p < 0.001). Oral manifestations, systemic involvement, medication, and periodontal indexes were significantly associated with OHIP-14 scores. Conclusions: Patients with oral alterations had a substantially decreased OHRQoL. These findings emphasize the importance of oral diseases for patients' well-being. Therefore, it is essential for dentists to be included in the multidisciplinary teams managing primary Sjögren's syndrome, as improving patients' oral status would lead to better oral health and enhanced OHRQoL.

Eksfolyatif keilit tedavisinde tildrakizumab

Exfoliative cheilitis is an inflammatory condition that can significantly impair quality of life. This is the first reported case of an interleukin-23 inhibitor, tildrakizumab, for the treatment of a chronic, refractory case of exfoliative cheilitis.

Factors Participating in the Occurrence of Inflammation of the Lips (Cheilitis) and Perioral Skin

Lip inflammation may manifest as mainly reversible cheilitis, mainly irreversible, or cheilitis connected to dermatoses or systemic diseases. Therefore, knowing a patient’s medical history is important, especially whether their lip lesions are temporary, recurrent, or persistent. Sometimes temporary contributing factors, such as climate and weather conditions, can be identified and avoided—exposure to extreme weather conditions (e.g., dry, hot, or windy climates) may cause or trigger lip inflammation. Emotional and psychological stress are also mentioned in the etiology of some lip inflammations (e.g., exfoliative cheilitis) and may be associated with nervous habits such as lip licking. To better manage cheilitis, it is also helpful to look for potential concomitant comorbidities and the presence of related diseases/conditions. Some forms of cheilitis accompany dermatologic or systemic diseases (lichen, pemphigus or pemphigoid, erythema multiforme, lupus, angioedema, xerostomia, etc.) that should be uncovered. Occasionally, lip lesions are persistent and involve histological changes: actinic cheilitis, granulomatous cheilitis, glandular cheilitis, and plasmacellular cheilitis. Perioral skin inflammation with simultaneous perioral dermatitis can have various causes: the use of corticosteroids and cosmetics, dysfunction of the skin’s epidermal barrier, a contact reaction to allergens or irritants (e.g., toothpaste, dental fillings), microorganisms (e.g., Demodex spp., Candida albicans, fusiform bacteria), hormonal changes, or an atopic predisposition. Epidermal barrier dysfunction can worsen perioral dermatitis lesions and can also be related to secondary vitamin or mineral deficiencies (e.g., zinc deficiency), occlusive emollient use, sunscreen use, or excessive exposure to environmental factors such as heat, wind, and ultraviolet light. Current trends in research are uncovering valuable information concerning the skin microbiome and disruption of the epidermal barrier of persons suffering from perioral dermatitis. Ultimately, an effective approach to patient management must take all these factors and new research into account.

Clinical predictors of metal allergic sensitization in orthodontic patients.

This study aimed to assess the predictors of allergic sensitisation to titanium and nickel in patients undergoing orthodontic treatment. A total of 250 patients undergoing orthodontic treatment were invited to participate, and 235 were analysed (67% females). A patch test was performed using nickel sulphate, titanium, titanium dioxide, titanium oxalate, titanium nitride, and petrolatum as control. In addition, clinical signs of the oral mucosa, gingiva, tongue, lips, and allergological history were assessed. The predictors of metal allergic sensitisation in patients undergoing orthodontic treatment were adult age (OR = 2.6; 95% CI: 1.2-5.5; p = 0.016), female sex (OR = 3.0; 95% CI: 1.1-7.9; p = 0.025), exfoliative cheilitis (OR = 4.8; 95% CI: 1.9-12.4; p = 0.001), history of contact hypersensitivity (OR = 7.0; 95% CI: 1.3-35.4; p = 0.025), history of contact hypersensitivity to metals (OR = 8.3; 95% CI: 1.4-50.2; p = 0.021), and piercings (OR = 5.4; 95% CI: 2.1-13.9; p = 0.001). When predictors were analysed separately for these two metals, titanium sensitisation predictors were contact hypersensitivity to metals and piercing, whereas nickel sensitisation predictors were age and piercing. A positive patch test alone cannot draw definite conclusions regarding allergy. However, metal allergies in patients with orthodontic appliances could be considered in cases of previous contact hypersensitivity, previous reactions to metals, exfoliative cheilitis, and piercing.

Exfoliative cheilitis: frequency of occurrence, clinical forms, unfavorable factors

As a result of the analysis of 1850 medical records of consultations, examination of 1159 patients of pediatric and adult therapeutic dental appointments and an in-depth examination of 89 patients, it was found that the prevalence of the dry form of exfoliative cheilitis in people of different ages is 1.55%, the exudative form of exfoliative cheilitis occurs in 0.27% of cases among patients with pathology of the oral mucosa and lips. Local and general unfavorable factors are observed in patients with cheilitis with a slightly higher, but statistically insignificant, frequency than among healthy people, but the role of psycho-emotional stress in exacerbating the disease is noted in 43.5% of patients.

Cheilitis: A cross-sectional study-multiple factors involved in the aetiology and clinical features.

Since the aetiologies of cheilitis are broad and overlapping, the purpose of this cross-sectional clinical study was to examine the multiple factors involved in aetiology and the disease's clinical features. We analysed cheilitis prevalence, demography, clinical features, patients' habits, psychological stress, systemic diseases, vitamin B9, B12 and iron serum levels and allergy test results in a total of 130 subjects with cheilitis, plus 22 healthy subjects. The most common cheilitis types were: cheilitis simplex and eczematous cheilitis (28.5%); herpetic cheilitis (16.9%); and exfoliative and angular cheilitis (7.7%). Concerning bad habits, there was a significant association/connection between self-reported saliva at the corners of the mouth and angular cheilitis, and between lip licking/biting and exfoliative cheilitis. Common associated conditions were skin diseases (56.5%) and atopy (84%). Vitamin B9 and B12 serum and iron values were mostly within the normal reference range. The patients suffering from herpetic cheilitis had significantly higher psychological/mental stress levels than the control group. To our knowledge, this is the first study of cheilitis patients that has simultaneously analysed aetiological factors, characteristics of the disease and diagnostic parameters.

Uremic stomatitis in patients with chronic renal failure undergoing hemodialysis

Patients with end-stage renal disease with or without hemodialysis are at risk of experiencing a number of comorbidities inclu-ding hypertension, anemia, risk ofbleeding and have oral manifestations related to the disease itself or due to hemodialysis; for example uremic stomatitis. This article describes uremic stomatitis in end-stage renal disease patient undergoing hemodialysis. A 14-year-old girl with chronic kidney disease had already undergoing hemodialysis, came with weak, pale condition and pre-viously vomiting, complaining sore mouth and difficult to eat. Extra oral revealed anemic conjunctiva, dry lips, exfoliative, ero-sive with serosanguinolenta crusts, tend to bleed, multiple purpuras and petechiae on the lower lip. Intra oral showed white plaque cannot be scrapped off on theventral tongue. Painful erosive area and white pseudomembranes on the lower labial mu-cosa, multiple white plaques can be scrapped off leaving erythematous area on the right buccal mucosa, purpura on the left buc-cal mucosa. Laboratory examination supported the diagnosis as as uremic stomatitis and exfoliative cheilitis. To overcome the complaints and improve the oral condition, the patient was treated with 0.12% chlorhexidine digluconate 0.12%, 0.9% NaCl solution, a mixture of tranexamic acid vials and aqua bides, and vaseline album. It was concluded that uremic stomatitis is an oral manifestation of end-stage renal disease, and appropriate therapy will improve the quality of life of the patient.

EXFOLIATIVE CHEILITIS: REPORT OF TWO CASES FOCUSING ON CLINICAL MANAGEMENT

This report describes 2 cases of exfoliative cheilitis, an uncommon inflammatory condition affecting the lips, characterized by chronic production and desquamation of thick keratin scales. A 34-year-old man with psoriasis presented with a 5-year history of persistent lip desquamation, reporting unsatisfactory results from previous treatments (topical corticosteroid, 5-fluorouracil, moisturizing agents, CO₂ laser ablation). Physical examination revealed lip erythema and desquamation. Treatment with topical corticosteroid was effective and prescribed as maintenance therapy. One year later, the condition recurred and was treated with a topical formulation containing clobetasol and salicylic acid. A 33-year-old woman, reporting anxiety and a habit of lip licking, presented with continuous lip peeling, crusting, and concurrent angular cheilitis. Treatment with dexpanthenol-containing ointment and miconazole gel was successful. Five months later, lip scaling and fissures were observed and treated with topical dexpanthenol-containing ointment. Anamnesis and clinical findings were essential for exfoliative cheilitis diagnosis in both cases, which remain under follow-up.

EXFOLIATIVE CHEILITIS: CASE REPORT IN A YOUNG PATIENT

Cheilitis is a general term for the inflammation of the lip. Exfoliative cheilitis is the rarest type of cheilitis and is characterized by superficial desquamation of the lip vermilion. We report a case of exfoliative cheilitis related to intense sun exposure in a 22-year-old White male patient with 4 months of evolution. The lips presented edema, dryness, desquamation, and multiple thick, yellowish-white crusts. Sialometry, serologic tests, and cytopathology showed no alterations. An incisional biopsy was performed, and the histopathologic examination revealed parakeratinized squamous epithelium with mild lymphocytic exocytosis and a scanty chronic inflammatory infiltrate in the underlying connective tissue. Treatment with topical corticosteroids was performed for 12 weeks and total remission of the lesions was observed. However, 2 months later, the lesions recurred and required topical corticosteroid intervention for another 12 weeks. After this treatment, complete healing occurred, and the patient remains in follow-up for 1 year.

MANAGEMENT OF RECURRENT EXFOLIATIVE CHEILITIS A/R LABIUM SUPERIOR AND INFERIOR IN PATIENT 12-YEAR-OLD

Exfoliative Cheilitis (EC) is a chronic inflammatory condition of the lips, characterized by fissuring, desquamation, and the formation of a bleeding crust. EC causes a burning sensation of varying intensity and sometimes bleeding. EC has no clear etiology but is associated with bad habits such as lip licking and biting, stress or depression, and systemic disease states. The best treatment for EC is to eliminate the cause or predisposing factor. Treatment was given in the form of topical corticosteroid application and petroleum jelly. The use of corticosteroids can be discontinued if there are no complaints and to overcome the dryness of the lips it is recommended to apply petroleum jelly. One week after the treatment, there was a wound healing process, but the condition of the lips still showed redness and the patient's lips were still peeling. After one month, the patient's lips have healed, and the patient's bad habits such as licking the lips and peeling the lips have disappeared.

&lt;strong&gt;Evaluation of severity level, stress, and bad habit among dental students with exfoliative cheilitis&lt;/strong&gt;

Introduction: Exfoliative cheilitis (EC) is one of the most common cheilitis found in the community. This lesion can cause difficulty in mouth opening, speech difficulties, and reduced aesthetical value of the lips. EC is a chronic inflammation characterised by desquamation, erythema, and crusting on the upper or lower lip. This study evaluated severity level, stress, and bad habit among dental students with exfoliative cheilitis. Methods: The method used in this research was descriptive with a total sampling method on the populations of dental students batch of 2016 to 2018 of the Faculty of Dentistry Universitas Padjadjaran, which obtained 83 dental students with EC. The lips were then examined, and data was recorded. EC was classified into three stages in clinical manifestation: mild, moderate, and severe exfoliative cheilitis. The data were presented with a simple frequency distribution table. Result: 30.1% of the research subjects had mild EC, 53% had moderate EC, and 16.9% had severe EC. The predisposing factors of EC in this research were stress and bad habits, where the percentage contribution were 53% and 16.9%, respectively. Students were also found with both stress and bad habits with a percentage contribution of 30.1%. Conclusions: Moderate exfoliative cheilitis is most commonly found with desquamation and erythema clinical features. The predisposing factor of exfoliative cheilitis is stress which has the highest percentage among dental students.