What is Cheilitis?

Cheilitis is a general term for inflammatory diseases that occur on the lips. Acute cheilitis and chronic cheilitis are classified according to the course of the disease; erosive cheilitis, eczema cheilitis, and desquamative cheilitis are classified according to the clinical symptoms; chronic non-specific cheilitis, glandular cheilitis, Benign lymphoproliferative cheilitis, granulomatous cheilitis, May-Raw syndrome, actinic cheilitis, and allergic cheilitis.

Basic Information

English name

cheilitis

Visiting department

Stomatology

Common locations

Lip

Contagious

no

Causes of cheilitis

Chronic non-specific cheilitis

The etiology is unknown, and may be related to some long-term persistent stimulating factors of temperature, chemical and mechanical. For example, addiction to tobacco, alcohol, hot food; bad habit of licking lips and biting lips. Related to mental factors.

2. Glandular cheilitis

The cause is unknown. Autosomal dominant inheritance is possible. Possible acquired factors include the use of toothpaste or mouthwash with sensitizing substances, trauma, smoking, poor oral hygiene, mood, etc. Some people think that the disease is a manifestation of Crohn's disease.

3. Benign lymphoproliferative cheilitis

The cause is unknown. It may be related to the proliferation of primitive lymphoid tissue remaining during embryonic development under light radiation.

4. Plasma cell cheilitis

The cause is unknown. May be related to local peripheral circulation disorders, endocrine disorders, diabetes, hypertension and other diseases; local long-term mechanical stimulation such as the stimulation of dentures, or light stimulation may also be the cause of the disease.

5. Granulomatous cheilitis

The cause is unknown. May be related to bacterial or viral infections, allergic reactions, vasomotor disorders, genetic factors, etc.

6. May-Roll syndrome

The cause is unknown. Genetic factors, infection factors, allergic factors, and vasomotor disorders may be related to the disease.

7. Actinic cheilitis

Actinic cheilitis is cheilitis caused by excessive sunlight. The cause is allergic to ultraviolet rays in sunlight.

8. Allergic cheilitis

Allergic cheilitis is caused by contact with allergens. Certain foods, drugs, infectious factors, mental factors, physical factors, etc. can all become causative factors of the disease.

Clinical manifestations of cheilitis

Chronic non-specific cheilitis

It can be divided into chronic desquamative cheilitis mainly based on desquamation and chronic erosive cheilitis mainly based on exudative erosion.

(1) Chronic desquamative cheilitis is more common in women before the age of 30. The lower lip is the most serious. The lighter is the desquamation, and the severer may have scaly. Can be secondary to infection with mild edema and congestion, and the condition persists for months to years.

(2) Chronic erosive cheilitis Erosion and exfoliation of lip red, inflammatory exudation, formation of yellow crusts, or coagulation into hemorrhoids after bleeding, or purulent secretions into pus after secondary infection. Recurrence can also temporarily heal, but often relapse.

2. Glandular cheilitis

It occurs in adult men and can be divided into three types: simple type, superficial suppurative type, and deep suppurative type.

(1) Simple glandular cheilitis The most common glandular duct openings are visible on the lips. Mucus-like substances are often discharged from the mouth.

(2) Superficial suppurative glandular cheilitis Caused by simple secondary infection, squeezing the glandular mouth to discharge slightly muddy or purulent fluid.

(3) Deep purulent glandular cheilitis is caused by repeated abscesses on the basis of simple type and superficial purulent type, which causes deep infection and suppuration, and fistula occurs. The disease can become cancerous, and most often develop from deep purulent types.

3. Benign lymphoproliferative cheilitis

There are more young women. The middle part of the lower lip is a good hair area. Damage is usually limited to less than 1 cm. The lip damage was initially dry, desquamated, or skinless, followed by erosion, covered with pale yellow crusts, and local paroxysmal severe itching.

4. Plasma cell cheilitis

It is mainly infringed on the lower lip, which is more common in middle-aged and elderly people. Small blisters began to appear on the lip and mucous membranes, and they quickly ulcerated and crusted. If the surface is not eroded, localized dark red edema plaques with a clear state can be seen. There may be atrophic changes of the mucosa at a later stage. But easy to relapse.

5. Granulomatous cheilitis

More common in young adults, onset and slow passage, more on the upper lip. Generally, swelling starts from the side of the lip. Swelling is characterized by painlessness, no itching, and no depression edema. With the development of the disease, it spread to the entire lip, forming a giant lip, and a left-right symmetrical longitudinal cracks appeared in a corrugated shape.

6. May-Roll syndrome

Patients are more common in young people under 20 years of age, and the triad of May-Raw syndrome is recurrent oral and facial swelling, recurrent peripheral facial paralysis, and cracked tongue.

7. Actinic cheilitis

The disease is more common in summer and has obvious seasonal factors. There are two clinical types.

(1) Acute actinic cheilitis has a history of sun exposure, acute onset, and frequent lower lip. It is manifested as extensive edema, congestion, erosion in the red lips area, covered with blood sacral, obvious burning sensation, severe itching, affecting the entire lower lip, affecting eating and speaking.

(2) Chronic actinic cheilitis Also known as desquamative cheilitis. In the early stage, the lower lip is dry and does not show white fine bran-like scales, which are easy to form wrinkles and clefts. If it is not cured for a long time, it easily develops into squamous cell carcinoma, and the disease is regarded as a precancerous state.

8. Allergic cheilitis

(1) Patients with neurovascular edema of the labial vasculature are acute, and the upper lip is more common than the lower lip. Itching, burning pain, and swelling followed. Edema can form within ten minutes and the surface is as shiny as wax. The swelling can resolve within hours or within 1 to 2 days without leaving traces.

(2) Contact cheilitis Local oral mucosal congestion and edema, or erythema formation, occur in 2-3 days after exposure to allergens, and severe cases of blisters, erosions or ulcers.

Cheilitis diagnosis

Chronic non-specific cheilitis

It can be diagnosed according to the repeated course, light and heavy, good onset in cold and dry seasons, dry and desquamated lips, pain, swelling, itching or exudation.

2. Glandular cheilitis

According to the enlargement and toughness of the glands, when the inner mucosa of the lip is opened, the large purple-red central depression of the catheter opening can be seen. There is mucus or purulent discharge, and miliary nodules on percussion. If necessary, a pathological examination should be performed to rule out cancer.

3. Benign lymphoproliferative cheilitis

It is not difficult to make a diagnosis based on local characteristics, recurrent severe itching, pale yellow mucus outflow, and crusting. The lymphoid follicular structure of the pathological section is helpful for pathological diagnosis.

4. Plasma cell cheilitis

It is difficult to diagnose based on clinical manifestations and is easily confused with other lip diseases. A diagnosis must be made through a histopathological examination.

5. Granulomatous cheilitis

It is not difficult to make a diagnosis based on diffuse and repeated swelling of the lips, irrecoverable symptoms, and percussion like padding, combined with histological examination.

6. May-Roll syndrome

Mainly relying on clinical symptoms, combined with histological examination, two main symptoms can be diagnosed as incomplete Mei-Luo syndrome, and all three main symptoms are diagnosed as complete, but rare.

7. Actinic cheilitis

Diagnosis can be made based on a clear history of light and clinical manifestations of eczema erosion or dry desquamation. Acute or chronic actinic cheilitis was diagnosed according to the course of the disease and whether it was erosion, crusting, or pruritus. Histological examination helps to determine the extent of the lesion.

8. Allergic cheilitis

(1) Neurovascular edema of the labial vessels is sudden and rapid; the lesions are localized edema, the boundaries are unclear, and the lesions are tough and elastic; the lesions disappear quickly without leaving traces.

(2) Contact cheilitis According to the clinical manifestations and history of allergies, the lesions were significantly improved and disappeared after the removal of local allergens.

Cheilitis Treatment

Chronic non-specific cheilitis

Avoid irritating factors and correct bad habits of licking and biting lips.

Antibiotic ointment or hormone ointment for dry desquamation. When exuding crusts, apply a wet compress first. For wet compress, use 5% saline.

Topical injections of triamcinolone suspension and the like help promote healing.

2. Glandular cheilitis

Inject local suspension of prednisolone or apply radioactive isotope ^32P . After infection control, chlortetracycline and glycerol can be used locally. For those who are suspected of having cancer on the lips, a biopsy should be performed as soon as possible to confirm the diagnosis.

3. Benign lymphoproliferative cheilitis

Avoid direct sunlight. Because the disease is sensitive to radiation, it can be treated with an isotope 32P, and the scalp skin can be removed by wet compressing with 0.1% isoxalate solution. Apply anti-inflammatory and exudative ointment topically.

4. Plasma cell cheilitis

The disease is relatively sensitive to radiation therapy, and severe cases can be treated with X-rays or local application of radioisotopes.

5. Granulomatous cheilitis

Taking or topical injection of corticosteroids has poor curative effect on corticosteroids or to avoid side effects caused by long-term application of corticosteroids, clofazimine, metronidazole, antibiotics, antihistamines, traditional Chinese medicine, and surgery can be used.

6. May-Roll syndrome

Corticosteroids can be used at an early stage, prednisone injection can be injected topically for a lip swelling, and 2% sodium bicarbonate solution, chlorhexidine solution can be used to gargle the cracked tongue. For those who have formed large lips for a long time, surgery, laser and radiotherapy can be considered.

7. Actinic cheilitis

The disease can become cancerous and should be diagnosed and treated early. Take chloroquine phosphate and multivitamin B. For local treatment, 3% chloroquine ointment and 5% titanium dioxide ointment can be used. There are exudative wet compresses on the lips, and the dry desquamation type can be topically applied with hormone or antibiotic ointments. Physical therapy. Surgical resection can be performed for patients suspected of being cancerous or already cancerous.

8. Allergic cheilitis

Identify and isolate allergens to relieve symptoms and prevent recurrence. For patients with mild symptoms, prednisone can be given orally. Antihistamines may be administered as appropriate.