What Is Cheilosis?

Cheilitis includes eczema-erosive cheilitis, dry desquamative cheilitis, also known as simple cheilitis or exfoliative cheilitis, glandular cheilitis, granulomatous cheilitis. The illness may be related to many factors such as mental, local irritation, environment, and drugs.

Basic Information

English name

lip disease

Visiting department

Stomatology

Common causes

Related to many factors such as mental, local irritation, environment, drugs, etc.

Common symptoms

The lip red part is diffuse flushing, desquamation, congestion, edema, erosion, exudation, etc.

Causes of Lip Disease

Dry desquamative cheilitis

The cause is unknown and may be related to mental factors, lip biting, licking lips, and so on. It is related to light or chemical factors such as inferior lipstick or spicy taste.

2. Eczema-erosive cheilitis

May be related to mental and disease, most of them may be related to various long-term chronic persistent stimuli, which can be caused by hot work or outdoor work and wind and sun, so it is called actinic cheilitis. Ingestion of foods containing porphyrin, taking western medicine chlorpromazine, isoniazid, etc., or using traditional Chinese medicine angelica, psoralen, etc., can make porphyrin metabolism disorder. In this case, after exposure to sunlight, It is highly allergic to ultraviolet rays and induces the disease. Other bad habits such as lip biting are also predisposing factors.

3. Glandular cheilitis

unknown reason. It may be caused by congenital or acquired factors; it may also be related to heredity, infection, and lesions; other such as mental and emotional changes, local stimulation, and even smoking may also be related to disease.

4. Granulomatous cheilitis

Most people think that this disease is an independent disease; others think it may be a delayed hypersensitivity reaction; it may be related to heredity, infection and other factors.

Clinical manifestations of labia

Dry desquamative cheilitis

Occurs in adolescent men and women. The lower lip is more than the upper lip, and there are concurrent lips. It is mainly manifested in the diffuse flushing of the red part of the lips, which is accompanied by dried pityriasis scales. Desquamation is its main feature, and the lips are dry and red, which can cause lip tissues to thicken or be accompanied by chapped skin after repeated days. Patients consciously experience local dryness and burning discomfort, so they often lick their lips. The course of the disease is slow and can last for months or even years.

If it is complicated by cleft palate, it is more common on the upper lip. Patients may cause bleeding and pain when they open their mouths. If the movement is not restricted, the cleft palate will not heal easily.

2. Eczema-erosive cheilitis

The clinical manifestations of various erosive cheilitis are similar, and they are only identified in histopathology. The two types that are easily confused are described below.

(1) Actinic cheilitis is mainly due to excessive sunlight exposure, which is caused by ultraviolet rays that damage the lip mucosa.

Generally, the following lips are more common. On the basis of congestion and edema of the red part of the lip, the main features are erosion and exudation. The general damage is limited to the red part of the lip, does not exceed the edge of the red part, and does not spread to the skin. There is a yellow exudate in the erosion area. With the reduction of inflammation, the exudation gradually decreases, until the scabs and the scabs heal. The infected erosive surface can be purulent. The patient was conscious of local burning, itching, and itching, and the corresponding lymphadenopathy was enlarged and tender. Pigmentation can be left in recurrent areas.

(2) The clinical manifestations of benign lymphoproliferative cheilitis are mainly erosion, which also occurs in the lower lip. Can be combined with dry cracks, desquamation, or polyps, granules, and verrucous hyperplasia. Short white lines can also appear, similar to discoid lupus erythematosus, but the lesions do not exceed the red lips. The patient was conscious of local dryness or itching and discomfort, and even felt pain.

3. Glandular cheilitis

More common in the lower lip, more common over 40 years old. Swelling and eversion of the lower lip are common. Due to the hypertrophy of the small salivary glands, palpation can touch miliary or small nodular glands. When the lower lip is opened and squeezed, transparent mucus overflows and dewdrops can be seen; pus can also overflow during infection. Some glandular duct openings are concave holes in the umbilicus. The patient consciously felt local discomfort, which can cause adhesion of upper and lower lips.

4. Granulomatous cheilitis

Occurs in late adolescence. It is common for the upper lip to swell and thicken. It has a sudden and diffuse swelling from the beginning, and the color is normal. Into huge lips. During the examination, there was no indentation when pressing, and the swelling tissue was found to be ductile, or rubber-like hardness. The patient consciously felt local swelling and strange feeling, and generally no pain.

Clinic diagnosis

Combining medical history and clinical signs, pathological examination can assist diagnosis.

Differential diagnosis of labiasis

Angioedema

It is an acute, sudden, transient, localized, and painless subcutaneous or submucosal edema. Some people think that it is a special type of urticaria. Although it suddenly occurs, it disappears quickly.

Sarcoidosis

It is a systemic granulomatous disease caused by cellular immune deficiency. The lips are dark red and swollen, and they are smooth and tough. They are not painful. The cheeks, palate, and jaw can also be affected, often invading the lungs, mediastinum, nearby lymph nodes, and liver Spleen, etc., X-ray examination showed hilar lymph node shadow.

Labiasis Treatment

(A) dry desquamative cheilitis

1. Look for pathogenic factors

Remove bad habits such as biting lips, licking lips or tearing scales with fingers; quit smoking, alcohol, hot, spicy and other special hobbies; maintain a balanced diet, regular life and a stable mood.

2. Avoid direct sunlight

Can be applied topically with sunscreens, such as 3% chloroquine ointment or 5% titanium dioxide ointment, and a sun hat for outdoor activities.

3. Isolate external stimuli and keep lips hydrated

In addition to ensuring adequate drinking water, topical application of honey, vaseline or glycerin can be applied.

4. Antibacterial and anti-inflammatory

For local congestion and edema, antibiotic ointments such as erythromycin ointment and tetracycline ointment can be used; adrenal corticosteroid preparations such as cheilitis ointment, ulcer cream, skin easy ointment, and dexamethasone ointment can also be used.

5. Physical therapy

Drug iontophoresis. In the absence of cleft palate, 10% potassium iodide can be used as iontophoresis therapy, and iodine ions can be introduced into the ward to reduce inflammation. Laser. Irradiated with a helium-neon laser, defocused, and the spot size is in degrees of the lesion size.

6. Submucosal injection in the ward

For those with deep grooves, inject 2.5% prednisone acetate suspension (in the same amount of 1% procaine solution to reduce pain) under the mucosa in the lesion area; It is possible to close the fissure groove, cover and fix the surface with medical glue, and make the patient pay attention to reduce the local movement by 3d, which is better.

7. Oral vitamins

To promote the normalization of epithelial metabolism, vitamin AD, vitamin C, and multivitamin B can be taken orally.

(2) Eczema-erosive cheilitis

Local treatment

(1) Wet compresses If there is a lot of erosion or exudate, 0.1% levonur or 0.02% furacicillin can be used for wet compresses.

(2) Anti-inflammatory Locally, prednisone acetate or triamcinolone plus an equivalent amount of 1% procaine solution can be used for submucosal injection in the ward; for erosive surfaces with significantly reduced exudation, antibiotics such as tetracycline or Erythromycin ointment is applied for anti-inflammatory and anti-infection; it can also be applied with adrenal corticosteroid preparations such as cheilitis ointment.

(3) Protect from light The sunscreen includes 3% chloroquine ointment or 5% titanium dioxide ointment. Or wear a visor when working outdoors or during activities.

2. Systemic treatment

(1) Chloroquine Orally take chloroquine. Pay attention to routine blood tests before medication, such as those with low white blood cell count with caution.

(2) Vitamins AD and Vitamin C are available for erosive lesions, which can promote healing.

(Three) glandular cheilitis

First, look for the cause, pay attention to quit bad habits and all stimulating factors, and maintain oral hygiene.

This disease is a chronic disease, which can be treated symptomatically. Topical application of 5% chlortetracycline hydrocortisone paste or cheilitis ointment, skin easy ointment, etc .; can also be injected with a strong Songlong suspension or antibiotic Anti-inflammatory and anti-infection; oral 10% potassium iodide has a certain effect, and can also be treated with radiation, such as ³² P topical application.

(D) Granulomatous cheilitis

Local treatment

(1) Local injection of adrenal cortex hormones, such as 2.5% prednisolone acetate suspension or 2.5% triamcinolone solution plus an equal amount of 1% procaine solution for local submucosal injection, once a week.

(2) Surgical resection For those who have not been cured for a long time, resection can be considered to restore the normal form.

(3) ³² P topical application is available as appropriate.

2. Systemic treatment

(1) Removal of lesions After oral cavity lesions are removed, they are treated with sulfa drugs or antibiotics.

(2) If appropriate, use an adrenal corticosteroid such as prednisolone, orally, and reduce the dose after the effect is maintained, and then decrease after the condition is stable.