PubMed · 11326711
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R Eng, E Gagari, M B Papageorge. 2001. A clinico-pathologic correlation. Erythema multiforme.. https://pubmed.ncbi.nlm.nih.gov/11326711/
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Cheilitis is clinically characterised by an acute or chronic inflammatory state of the lips, limited to the vermillion border. The term "angular" cheilitis applies to localise bilateral lesions of the angles of the mouth. Acute cheilitis is erythematous or erosive, accompanied by a stinging sensation. Chronic cheilitis is for the most part erythemato-squamous, and is often asymptomatic. The classification of cheilitis is based on the aetiology, being most often an allergy, an infection or a physical irritation, potentially favourised by particular anatomical conditions. However, the distinction between the diverse types is sometimes blurred as diverse causes can co-exist.
Buccal mucosal allergies are rare because the conditions for sensitization are less favourable in the buccal environment. Clinical presentation is dominated by subjective manifestations (hardening, hypersialorrhea, "burning mouth" syndrome). Extradental etiologies are linked with cosmetic and medicinal topics, as well as dental etiologies caused by metals, alloys of mercury and resins.
A 48-year-old man, otherwise in good health, was seen with a chronic painful fissure of the upper lip mucosa. For at least 2 years it had failed to respond to a variety of topical agents. Though not previously reported, the primary etiologic factor was thought to be irritation from contact with his misaligned anterior teeth. Eight months into orthodontic treatment, the lesion healed and did not return. Orthodontics included preadusted edgewise mechanics. However, the right maxillary lateral incisor was not bracketed but instead guided into position by direct contact with the archwire.