[Exfoliative cheilitis - fissure cheilitis - abrasive cheilitis].
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Cheilitis↗
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[Schizophrenia and factitious cheilitis: a case report].
Factitious Cheilitis is a rare skin disorder which has been seen in patients with emotional disturbances, particularly in cases with neurotic and personality disorders. However, there have been no reports of factitious cheilitis seen in cases of schizophrenia. This study reports on a case of schizophrenic disorder, where the patient was observed to develop factitious cheilitis whilst subject to unstable psychiatric conditions. The case reported here is of a 59 year-old female widow, who has experienced the delusion of being controlled, the delusion of being possessed. Been subject to auditory hallucination and vague somatic pain for eight years and had a very poor psychotropic drug compliance. Observation revealed frequent licking of the lips unrelated to drug-induced dyskinesia, but as a possibly linked response to hallucination whilst subject to an intense unstable emotional and painful state. Factitious cheilitis was proved with biopsy of the lips and pathological findings of acanthosis, hyperkeratosis and parakeratosis. After psychiatric and dermatologic care, her cheilitic condition improved. This study demonstrates that factitious cheilitis can be seen in a schizophrenic patient, specifically where hallucination and emotional instability coupled with long-term licking of the lips can result in factitious cheilitis. The relationship of skin disorder and psychiatric illness is discussed.
Cheilitis↗
[Cheilitis caused by photosensitization].
Many clinical entities show manifestations in the lips and sometimes such localization is eminent. In the photodermatosis there are different degrees of compromise of the lips. In the Polimorphus Light Eruption the cheilitis is a very common feature in the tropics and sometimes is the only manifestation of the disease for some time, or is accompanied by scant elements in the face and forearms. It is necessary to distinguish between chronic Antinic Cheilitis and the Eczematous cheilitis produced by the photosensitizing action of very well known substances contained in lip-sticks. The exfoliative cheilitis sometimes is found in atopic patients or patients with emotional disturbances. The Cheilitis present in patients with actinic chronic dermatitis are able to transform in Epithelioms.
Adult↗
The actinic cheilitis of hereditary polymorphic light eruption.
Sixty-four North American Indians with hereditary polymorphic light eruption (HPLE), or a family history of HPLE, had chronic, recurrent, exudative, and exfoliative cheilitis. Fifty-two had the cheilitis by the age of 10 years. Microscopically, the epithelium was either thickened, or thinned and covered by a thick crust. The dermis had a dense infiltration of inflammatory cells, mostly lymphocytes and plasma cells. The condition was not premalignant. The HPLE has to be differentiated from the chronic actinic cheilitis caused by long exposure to sunlight with out any element of hypersensitivity. The latter is potentially premalignant. Chronic recurrent actinic cheilitis associated with hereditary polymorphic light eruption appears to be a specific characteristic of photosensitivity occurring in American Indians. Plasma cell infiltration is not specific for either type of cheilitis.
Adolescent↗
[Successful treatment of cheilitis granulomatosis with potent inhibitors of mediator release--possible involvement of mast cells in the pathogenesis].
We report two cases of patients with cheilitis granulomatosis treated successfully with tranilast and ketotifen, both of which are known to be potent inhibitors or mediator release from mast cells. In one patient, complete resolution of the lesion occurred after 1 year of therapy. In another patient, the lesion also showed consistent, if not complete, improvement during the course of therapy. Because of the mechanism of the action, these agents have been widely used as therapeutic modalities for mast-cell-related diseases. We therefore measured numbers of mast cells in the lesions of cheilitis granulomatosis, in comparison with those in mucous cyst and lichen planus. Light microscopy of toluidine-blue-stained sections showed that mast cells, particularly those with ongoing degranulation, increased in number in the reticular dermis of the lesions of cheilitis granulomatosis. These findings suggest that mediators released from mast cells may be critical for the granulomatous inflammation in cheilitis granulomatosis.
Adolescent↗
Actinic cheilitis. Treatment with the carbon dioxide laser.
Actinic cheilitis is a premalignant condition that can be treated in several ways. A total of 43 patients with biopsy-proven actinic cheilitis were treated with the carbon dioxide (CO2) laser. After follow-up of at least 10 months, 26 patients thought that the lip was cosmetically improved, and 40 thought that the function of the lip was improved or had not changed. Complications were few and included only mild hypertrophic scarring, which resulted most often from the diagnostic biopsy and was corrected with topical or intralesional steroids or no therapy except simple massage. The CO2 laser is a simple, inexpensive, effective therapy for actinic cheilitis.
Adolescent↗
Angular cheilitis in a group of Sri Lankan adults: a clinical and microbiologic study.
The relative importance of various factors in the pathogenesis of angular cheilitis in a population of Sri Lankan adults was studied. Forty-nine patients with cheilitis were examined clinically and microbiologically. Only 5 of 49 patients were full denture wearers. The clinical presentation of the lesions could be categorized as mild (Type I), moderate (Type II) or severe (Type III) and the duration of the lesions ranged from 1 month to more than 4 yr. Hematologic investigations revealed 18 patients with low hemoglobin 8 of whom had hypochromic, microcytic anaemia. Pathogenic organisms were isolated from 59% of the lesions; Candida spp. in 24 patients and Staph. aureus in 11 patients. A significant positive relationship between commissural leukoplakia and an infective etiology of angles was noted. This study confirms the multifactorial etiology of angular cheilitis while highlighting the varied clinical presentation of the lesions in an Asian population.
Adolescent↗
Angioedema, elephantiasis nostras, and cheilitis granulomatosa.
Angioedema of the face is a common entity seen by the allergist, but other less common conditions should also be considered in the differential diagnosis of facial swelling. Elephantiasis nostras is a rare condition that can result in persistent swelling of the lips secondary to recurrent attacks of lymphangitis caused by bacterial infection. Cheilitis granulomatosa is a disorder that may also present with lip swelling. We present a patient with persistent swelling of his lips who was referred to our service to consider an allergic cause. The clinical findings of persistence of the swelling without improvement after therapy with corticosteroids and antihistamines are considered consistent with elephantiasis nostras or cheilitis granulomatosa. The histopathologic findings in this case revealed epithelioid cell granulomas, which are consistent with cheilitis granulomatosa. These two disorders should be included in the differential diagnosis of localized swelling of the face.
Adult↗
Granulomatous cheilitis. A review and report of a case.
The Melkersson-Rosenthal syndrome (MRS) is a rare triad of unilateral facial paralysis, facial swelling, and fissured tongue; often only two of the components are manifest. The occurrence of swollen lips together with the characteristic microscopic appearance is called granulomatous cheilitis, which many believe is the oligosymptomatic form of MRS. This article reviews the literature on granulomatous cheilitis associated with MRS. An unusual case of a swollen upper lip together with a fissured tongue, strongly indicating the oligosymptomatic manifestations of MRS, is presented.
Adult↗
Management of cheilitis granulomatosa.
Peripheral facial nerve palsy, recurrent or persistent oral or facial swelling, and fissured tongue constitute a triad of symptoms known as Melkersson-Rosenthal syndrome. Granulomatous labial enlargement, known as cheilitis granulomatosa, is considered the single most important diagnostic feature of this syndrome. This lesion has been difficult to treat. This article describes a case of 8 months' duration of cheilitis granulomatosa of the lower lip, which was successfully managed with intralesional steroid injections.
Administration, Topical↗
Carbon dioxide laser treatment of actinic cheilitis. Clinicohistopathologic correlation to determine the optimal depth of destruction.
BACKGROUND: The carbon dioxide laser is an effective modality for the treatment of actinic cheilitis, but the number of passes required is unknown. After each pass different visual tissue qualities are observed. OBJECTIVE: Our purpose was to identify and characterize histologically the tissue zones seen after laser impact and thereby to determine the optimal depth of destruction of diseased tissue. METHODS: Twenty-three biopsy specimens from 14 patients were obtained from zones of different tissue qualities after one and three passes with the laser. Specimens were histologically examined for the presence or absence of diseased epithelium and degree of thermal necrosis. RESULTS: Complete destruction of the epithelial layer was observed in all specimens irrespective of the number of laser passes. The amount of dermal homogenization increased with multiple passes. CONCLUSION: Treatment to the first or second surgical zone is effective for actinic cheilitis.
Adult↗
Phenotypic characterization of mononuclear cells and class II antigen expression in angular cheilitis infected by Candida albicans or Staphylococcus aureus.
In the present study we characterized the phenotypes of infiltrating mononuclear cells in angular cheilitis lesions to further explore the pathogenesis of this disorder. Frozen sections from lesions infected by Candida albicans and/or Staphylococcus aureus were subjected to immunohistochemical analysis utilizing monoclonal antibodies directed to subsets of T-lymphocytes, B-lymphocytes, and macrophages. In addition, the expression of Class II antigens (HLA-DP, -DQ, -DR), the interleukin 2- and transferrin-receptors was studied on resident and infiltrating cells. An intense infiltration of T-lymphocytes was accompanied by expression of Class II antigens on the epidermal keratinocytes in lesion infected by Candida albicans. The Staphylococcus aureus infected lesions displayed a diffuse infiltration of T-lymphocytes but virtually no expression of Class II antigen by epidermal keratinocytes. These observations suggest that the cell-mediated arm of the immune system is involved in the inflammatory reaction of lesions infected by Candida albicans. In addition, the present study confirms that epidermal expression of Class II antigens is closely related to the type and magnitude of the infiltrating T-lymphocyte. Finally, these findings indicate that the type of inflammatory reaction in angular cheilitis is primarily dependent on the isolated microorganism, although the clinical pictures of the disorder are virtually identical.
Adult↗
Granulomatous inflammation of the vulva and penis--a genital counterpart to cheilitis granulomatosa.
3 patients are described, in whom chronic swelling of the external genitals occurred after recurrent infections. The histological findings were identical to those seen in cheilitis granulomatosa, the dermal component of Melkersson-Rosenthal syndrome. The authors suppose that the disease of the 3 patients is a genital counterpart to cheilitis granulomatosa, and the name vulvitis or posthitis granulomatosa is suggested.
Adult↗
Iron deficiency: an overlooked predisposing factor in angular cheilitis.
Clinicians who recommend the use of antifungal agents for angular cheilitis may be treating the symptoms and not the predisposing cause of the disease. Iron deficiency should be considered as part of the differential diagnosis whenever angular cheilitis is encountered, especially in women of child-bearing age.
Adult↗
Cheilitis glandularis: a pediatric case report.
Cheilitis glandularis is a rare disorder, usually affecting the lower lip of adults. This case involved both lips of an adolescent male. A familial history of the condition may have contributed to the involvement of both lips, and may reinforce the importance of hereditary tendency in the development of cheilitis glandularis. Emotional disturbance and poor oral hygiene also had a role in the disorder in this case, which was successfully treated with surgery.
Cheilitis↗
Cheilitis glandularis: report of a case affecting the upper lip.
Cheilitis glandularis is a rare disorder characterized by swelling of the lip with hyperplasia of labial salivary glands, typically in the lower lip of adult males. A definitive cause and treatment for this disorder have not yet been established. Herein is reported a case of cheilitis glandularis affecting the upper lip with nodules, treated by surgical excision with good post-surgical results.
Cheilitis↗
[Granulomatous cheilitis and Crohn's disease].
A case of Cheilitis granulomatosa is described. The various etiologic hypotheses concerning the disease are summarized and a relation with Crohn's disease is emphasized in this case. The Cheilitis granulomatosa Miescher is to be considered as a cutaneous symptom which can be observed in various diseases (e.g. sarcoidosis, herpetic infections. Crohn's disease, panniculitis).
Cheilitis↗
[Cheilitis granulomatosa as the first manifestation of Crohn's disease].
A 39-year-old man developed a painless swelling of the lower lip, which histologically was a granulomatous inflammation of the corium as in granulomatous cheilitis. Four weeks after onset of the disease recurrent diarrhoea set in, the result of Crohn's disease of the jejunum, terminal ileum and caecum. Granulomatous cheilitis, occurring as sole sign of the Melkersson-Rosenthal syndrome, is a manifestation of Crohn's disease. Even if there are no intestinal symptoms. Crohn's disease must be excluded in the differential diagnosis.
Adult↗