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Types, Clinical Presentation, and Management of Cheilitis
abstract
This abstract is available on the publisher's site.
Access this abstract nowCheilitis, 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.
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Cheilitis: A Diagnostic Algorithm and Review of Underlying Etiologies
Dermatitis 2024 Feb 29;[EPub Ahead of Print], D Narayanan, M RoggeFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Cheilitis is a relatively common condition encountered in dermatology practices. The evaluation of a patient with cheilitis requires a thorough approach to identify a possible underlying cause owing to similar clinical presentations across various conditions. This article provides a comprehensive overview of the different etiologies of cheilitis and proposes a diagnostic algorithm for effective management.
The authors emphasize the importance of obtaining careful history and physical examination when approaching a patient presenting with cheilitis. Dermatologists should identify potential triggers such as UV light exposure, changes in lip- or oral-care products, dietary habits, recent dental procedures, and compulsive behavior, including lip-licking, skin picking, or exfoliation habits. Additionally, it is crucial to investigate the presence of comorbidities, including atopy, immunosuppression, alcohol abuse, malnutrition, malabsorption, or a history of anxiety, lupus, lichen planus, or allogeneic bone marrow transplantation.
When conducting a physical examination of a patient with cheilitis, the authors acknowledge the importance of documenting the degree of lip involvement (upper and/or lower vermillion lip or lip commissures) and distinct manifestations, such as fissuring, pustules, ulcerations, lichenoid changes, lip swelling, and any involvement of the perioral skin or oral mucosa. Any cutaneous involvement elsewhere in the body should be assessed. A biopsy may be required for certain cases of cheilitis for definitive diagnosis.
The proposed diagnostic algorithm presents a practical approach to diagnosing cheilitis, serving as a valuable tool that can be easily integrated into daily dermatology clinical practice.