[20] "Pigmented contact cheilitis" is one type of allergic cheilitis in which a brown-black discoloration of the lips develops. The terms "Candidal cheilitis"[24] and "bacterial cheilitis"[25] are sometimes used, denoting the involvement of Candida organisms and bacterial species respectively. ... Q-switched 532 nm Nd:YAG laser therapy for physiological lip hyperpigmentation: novel classification, efficacy, and safety, Journal of Dermatological Treatment, 10.1080/09546634.2020.1805400, (1-21), (2020). Cheilitis is an inflammation of the lips, typically causing peeling, cracking and soreness. Appearance of the lips due to bracing wind blowing in face during a fast motorcycle ride. [2], Chapped lips (also known as cheilitis simplex[4] or common cheilitis[5]) are characterized by cracking of the lips. It causes inflammation and swelling of lips and this disease is similar to that of actinic keratosis which is marked by skin rash caused by exposure to sunlight. Search for more papers by this author. [24] Although there may be associated erythema and edema. [22 [en.wikipedia.org] Cheilitis — codes and concepts open What is cheilitis ? Some components of lipcare products can be both irritant and allergenic. A related condition is Melkersson–Rosenthal syndrome, a triad of facial palsy, chronic lip edema, and fissured tongue. [11][32] Uncommon causes include Atorvastatin, Busulphan, Clofazimine, Clomipramine, Cyancobalamin, Gold, Methyldopa, Psoralens, Streptomycin, Sulfasalazine and Tetracycline. In fact this is herpes labialis, and is sometimes termed "angular herpes simplex".[27]. [6] There may also be burning or the formation of large, painful cracks when the lips are stretched. 2008 Aug;59(2):117-8. doi: 10.1111/j.1600-0536.2008.01334.x. [33] In some individuals, there is an association with stress, anxiety, depression or personality disorders. Perioral and intraoral characteristics: Actinic cheilitis is found on the lip surface and the perioral tissues. A previous classification suggested dividing cheilitis into 3 types based on severity, with the later stages involving secondary infection with bacteria, and increased ulceration, suppuration and swelling: Type 1, Simple; Type 2, Superficial suppurative ("Baelz's disease"); and Type 3, Deep suppurative ("cheilitis glandularis epostemetosa"). There was no improvement with a variety of different topical agents. They work as a natural hydrator, which helps in plumping up the skin cells, thus making the lips look healthy. [23][26], Exfoliative cheilitis has also been linked to HIV/AIDS. [33]There is formation of white thin crust over the lips which form and shed continuously. ( 12 ) reported a Philippina patient who presented with hyperpigmentation of her lips from the use of lipstick. Pigmented contact cheilitis: from green tea? [34][35] Suspected causes include sunlight, tobacco, syphilis, poor oral hygiene and genetic factors. [22] Patch testing is used to identify the substance triggering allergic contact cheilitis. Many conditions and factors can precipitate transient or chronic cheilitis, including overexposure to the sun, nutritional deficiencies, allergies, medications, dehydration, diet and certain systemic diseases. [36] The lips appear dry, atrophic and fissured. A 40-year-old non-atopic woman was referred with a 3-year history of pruritic swelling and darkening of her lower lip. [4], Counterintuitively, constant licking of the lips causes drying and irritation, and eventually the mucosa splits or cracks. The term "cheilocandidiasis" describes exfoliative (flaking) lesions of the lips and the skin around the lips, and is caused by a superficial candidal infection due to chronic lip licking. Pigmented contact cheilitis to paraphenylenediamine. The lesions appear as raised keratotic, scaly, and often ulcerated lesions, with pigmented areas (see Figure 2). [11] This habit is sometimes termed perlèche (derived from the French word pourlècher meaning "to lick one’s lips"). [28] Angular cheilitis may also be associated with orofacial granulomatosis. [15] Plasma cell cheilitis usually involves the lower lip. ", Journal of Indian Society of Periodontology, "Oral manifestations of systemic disease", Hereditary benign intraepithelial dyskeratosis, Neuralgia-inducing cavitational osteonecrosis, https://en.wikipedia.org/w/index.php?title=Cheilitis&oldid=1000136688, CS1 maint: DOI inactive as of November 2020, Articles with unsourced statements from August 2013, Creative Commons Attribution-ShareAlike License. [17] Allergies to metal, wood, or other components can cause cheilitis reactions in musicians, especially players of woodwind and brass instruments,[18] e.g., the so-called "clarinetist's cheilitis",[19] or "flutist's cheilitis". Common causes of drug-related cheilitis include Etretinate, Indinavir, Protease inhibitors, Vitamin A and Isotretinoin (a retinoid drug). Clinical examination should include, in addition to the lips, the inside of the mouth and general skin. [7], Some children have a habit of sucking and chewing on the lower lip, producing a combination of cheilitis and a sharply demarcated perioral erythema. Rarely are infections to blame. Pigmented contact cheilitis is generally a response to an allergy. Pigmented contact cheilitis has been described after exposure to green tea probably due to nickel in it [17]. [4] [23] Infectious cheilitis. Cheilitis glandularis usually occurs in middle-aged and elderly males, and it carries a risk of malignant transformation to squamous cell carcinoma (18% to 35%). The latter is characterized by a dryness, fissuring, edema, and crusting. Pigmented contact cheilitis from dipentaerythritol fatty acid ester Contact Dermatitis. [29] "Miescher’s cheilitis",[30] and "granulomatous macrocheilitis",[31] are synonyms of granulomatous cheilitis. [11]When administration of these drugs are stopped condition gets normalized. Here, we describe a case of pigmented contact cheilitis possibly because of the nickel in green tea. [16] A lipstick allergy can be difficult to diagnose in some cases as it is possible that cheilitis can develop without the person even wearing lipstick. Irritant contact cheilitis is a diagnosis of exclusion, made when examinations for an allergic cause have been negative, the patient is not atopic and lip-licking has actually not been observed. [26] The openings of the minor salivary gland ducts become inflamed and dilated, and there may be mucopurulent discharge from the ducts. Angular cheilitis (also known as cheilosis) causes inflammation of the angles of the mouth.[11]. Cheilitis is a medical condition characterized by inflammation of the lips. More than lipstick alone can lead to contact cheilitis, though. Irritants include spices, artificial flavors, harsh soaps, toothpaste, moisturizers, lip balms, Contact Cheilitis is caused by exposure to irritating chemicals, which can be found in food and skin care products. Please enable Javascript functionality in your browser so you do not see this message again. Also termed "lip dermatitis",[13] eczematous cheilitis is a diverse group of disorders which often have an unknown cause. Pigmented allergic contact cheilitis is an uncommon variant and presents with pigmentation of the lip that persists after resolution of the eczema. 6. Atopic dermatitis is commonly associated with contact cheilitis. [10] There is a small risk that this condition can develop into squamous cell carcinoma in the long term,[11] but lip cancer is usually noticed early and hence has a good prognosis compared to oral cancer generally. Actinic cheilitis is a disorder that is indicative of development of cancer. [26] Preventative treatment such as vermilionectomy ("lip shave") is therefore the treatment of choice. Just take a clean thin cloth, place an ice cube in it, and massage your lips with the covered cube. These cookies help us provide you with personalized content and improve our website. [1] The lips have a greater tendency to dry out in cold, dry weather. According to its onset and course, cheilitis can be either acute or chronic. ... Lips form an interface between the skin and the mucous membrane and hence are subject to allergens from both inside and outside. With emphasis being now on good looks, the use of cosmetics and dyes is quite rampant. Also termed "lip dermatitis", eczematous cheilitis is a diverse group of disorders which often have an unknown cause. [27] Factitious cheilitis is significantly more common in young females. ’89) Inaugural recipient of the Mallory Callan Memorial Scholarship. testing failed to elucidate the exact allergen [16]. [26], Herpes labialis (cold sore) is a common cause of infectious cheilitis. Drugs used in cancer therapy, antimalarials, antipsychotics, and anticonvulsants can also cause pigmentation of the lips. Purpuric Dermatitis Treatment and therapies. [16], The most common causes of allergic contact cheilitis is lip cosmetics, including lipsticks and lip balm, followed by toothpastes. [33] The condition has not yet been attributed to any particular cause. [8], Sometimes the term "cheilitis simplex" is used interchangeably with cheilitis in general;[1] however, exfoliative cheilitis is also sometimes stated to be the equivalent of chapped lips.[9]. Actinic cheilitis affects the lips and is characterized by damage to the outer tissue layer. Irritant contact cheilitis occurs as a result of external irritation, such as lip licking, cosmetics, and environmental factors. mucosa. Department of Dermatology. [26] Management consists mostly of keeping the lips moist and the application of topical corticosteroids ranging from hydrocortisone to clobetasol. Mehta et al. It's most commonly found on your face, lips, ears, back of your hands, forearms, scalp or neck.Also known as a solar keratosis, an actinic keratosis enlarges slowly and usually causes no signs or symptoms other than a patch or small spot on your skin. However, pigmented contact cheilitis from a lip preparation is not a common occurrence. Baik Kee Cho. This disorder is marked […] [10], Allergy to Balsam of Peru can manifest as cheilitis. Here are some other fairly common culprits: The lips develop a discoloration of dark purple or black spots, preceded by itching, burning, and swelling. A 47-year-old male presented with complaints of hyperpigmentation over his lips for the past few months. Hemmer et al. [1], Treatment is usually successful with the use of topical medications[4] Medical grade (USP) lanolin accelerates the repair of the lips. [23] Some consider habitual lip licking or picking to be a form of nervous tic. Lip cosmetics are the most common cause of allergic contact cheilitis. I was able to focus on my art and academic work without the stress of worrying how I was going to afford tuition.”, André Lucero (B.A. Consenting to VCU's privacy policy requires the use of Javascript. Pigmented contact cheilitis is a discoloration as a … Mehta V, Nayak S, Balachandran C - Indian journal of dermatology (2010) Follow us on social media! By clicking on "I agree", you agree to this use. Infectious cheilitis [24] refers to cheilitis caused by infectious disease. “As a young student, that recognition helped me realize that I had what it was going to take to pursue art as a career. Pigmented contact cheilitis from dipentaerythritol fatty acid ester. Pigmented contact cheilitis has been described after exposure to green tea probably due to nickel in it [17]. Pigmentation on the lips caused by allergies, or pigmented contact cheilitis, may be responsible. Common products that cause cheilitis are face makeup, hair dye, lipsticks, and green tea. It is characterized by whitish or grayish discoloration and hyperkeratotic changes, which often blunt the demarcation point between the mucosa and skin of the lower lip (Figure 1). Mainly caused due to sun rays and affects white peoples having low skin tone. Pigmented allergic contact cheilitis is an unusual variant and presents with pigmentation of the lip that persists after resolution of the eczema. Contact cheilitis Lips are between the skin and the ora! Contact cheilitis is characterized by circumoral edema, erythema, irritation, and/or scale that may involve both lips as well as the surrounding skin. Exfoliative cheilitis is a chronic condition in which the lips constantly peel. [citation needed] Chronic cheilitis simplex can progress to crusting and bleeding. [26], Media related to Cheilitis at Wikimedia Commons, "Journal of the American Academy of Dermatology", Volume 56, Issue 2, Pages AB94 – AB94, CS1 maint: DOI inactive as of November 2020 (, Journal of the American Academy of Dermatology, Volume 54, Issue 2, Pages 336–337 Instead, small exposure such as kissing someone who is wearing lipstick is enough to cause the condition. It's more common in women, probably because they are much more likely to wear lipstick, one of the most frequent causes of contact cheilitis. P. Carrington, T. Horn, "Angular Cheilitis, Part 1: Local Etiologies", "Contact allergy in chronic eczematous lip dermatitis", "Contact cheilitis and other reactions involving the lips of musicians on DermNet NZ", "Pigmented contact cheilitis on DermNet NZ", "Angular cheilitis, part 1: local etiologies", "Review article: orofacial granulomatosis", "Successful treatment of Miescher's cheilitis in Melkersson-Rosenthal syndrome with betamethasone injections and doxycycline", "Plasma cell gingivitis associated with cheilitis: A diagnostic dilemma! reported a case of pigmented contact cheilitis due to Paraphenylenediamine PPD following hair dye application to the moustaches [18]. Pigmented contact cheilitis: from green tea? We herewith report a case of pigmented contact cheilitis to PPD in a male who had no evidence of facial pigmentation. [1] Allergic tests may identify allergens that cause cheilitis. [15] There may also be ulceration, crusting, abscesses, and sinus tracts. Actinic cheilitis is a precancerous condition of the lip caused by long-term sun exposure. Angular cheilitis refers specifically to inflammation at the corners of the mouth. [citation needed] Digestive enzymes present in the saliva may also irritate the lips, and the evaporation of the water in saliva saps moisture from them. Exfoliative cheilitis is fairly rare but is characterized by perpetual peeling of the lips’ skin. [14] Chronic eczematous reactions account for the majority of chronic cheilitis cases. This inflammation can cause a variety of signs and symptoms, such as dryness, scaling, crusting, fissuring, erythema, edema and/or angular cheilitis, as well as burning or itching (9,10). This condition is also called as “farmer’s lips” or “sailor’s lips”. Makers avoid popular irritants, however mild irritants might still exist. [20] A lesion caused by recurrence of a latent herpes simplex infection can occur in the corner of the mouth, and be mistaken for other causes of angular cheilitis. They are covered by a pseudomucosa which, lacking the protection of a horny layer, makes them highly exposed to various harmful agents, including physical and chemical agents that act by contact with the lips (1). The lower lip may periodically become thicker than normal. 18 December, 2018. [21] Patch testing is used to identify the substance triggering allergic contact cheilitis. }, author={J. I. Lee and B. Cho and S. M. Ock and H. Park}, journal={Contact Dermatitis}, year={2010}, volume={62} } Contact cheilitis is a term used to describe inflammation of the lips, most often caused by either irritant contact cheilitis (ICC) or allergic contact cheilitis (ACC) (9). Pigmented contact cheilitis" is one type of allergic cheilitis in which a brown-black discoloration of the lips develops. The effects will be visible instantly. This page was last edited on 13 January 2021, at 19:30. An actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on your skin that develops from years of exposure to the sun. It is one of the causative allergen in cases of pigmented cosmetic dermatitis occurring on the face in the Indian population. Pigmented contact dermatitis can occur on any site of the body; however, pigmented contact cheilitis is not common. There have also been reports of using topical tacrolimus ointment. Pigmented contact cheilitis to paraphenylenediamine. There was no recent change in lip exposures. [26] Impetigo (caused by Streptococcus pyogenes and/or Staphylococcus aureus), can manifest as an exfoliative cheilitis-like appearance. [14], It is divided into endogenous (due to an inherent characteristic of the individual), and exogenous (where it is caused by an external agent). Dark lips can also occur as a side effect of chemotherapy or radiation therapy. To learn more about our web site privacy practices, please review VCU's privacy statement. [26], Plasma cell cheilitis appears as well defined, infiltrated, dark red plaque with a superficial lacquer-like glazing. For some people, soap of any kind may be too harsh for the face and lips. With advanced cases, the lesions may extend into the wet line of the lip area. [26] Angular cheilitis is sometimes also present. "Median cheilitis" may be seen, which is fissuring in the midline of the lips due to the enlargement of the lips. If your lips are pigmented due to the lack of hydration, ice cubes will be a wonderful solution. Pigmented contact cheilitis" is one type of allergic cheilitis in which a brown-black discoloration of the lips develops. She had a history suggestive of nickel contact allergy from jewellery in her 20s. [4][6] The lower lip usually becomes inflamed. Contact cheilitis may be due to an immunologic allergic reaction or more commonly may be due to an irritant reaction . [10][33] In one report, 87% of individuals had some form of psychiatric disturbance, and 47% had thyroid dysfunction, which in turn can cause psychiatric conditions like depression. [15] It affects females more commonly than males, in a ratio of about 9:1. Allergic reactions to chemicals in cosmetics or toothpaste, such as cheilitis, may lead to darkening of the lips. [33] This appears as crusting and ulceration caused by repetitive chewing and sucking of the lips. The main cause of endogenous eczematous cheilitis is atopic cheilitis (atopic dermatitis), and the main causes of exogenous eczematous cheilitis is irritant contact cheilitis (e.g., caused by a lip-licking habit) and allergic contact cheilitis. [2][22], Infectious cheilitis[23] refers to cheilitis caused by infectious disease. [26], Some cases of exfoliative cheilitis are thought to represent factitious damage, termed "factitious cheilitis" or "artifactual cheilitis",[23][24][26][27] and are related to repetitive lip picking or licking habits. Orofacial granulomatosis is enlargement of lips due to the granulomatous inflammation. Mehta et al. In this case, the patient was a 50-year-old female smoker who for 7 years had experienced "two darker brownish-pigmented lines from the nostril to the upper lip." Jae In Lee. @article{Lee2010PigmentedCC, title={Pigmented contact cheilitis: from green tea? Download Citation | On Aug 1, 2003, Yung-Hian Leow and others published Pigmented contact cheilitis from ricinoleic acid in lipsticks | Find, read and cite all the research you need on ResearchGate [15], This is an inflammatory condition of the minor salivary glands, usually in the lower lip, which appears swollen and everted. [33], Also termed "cheilitis exfoliativa" or "tic de levres",[11] is an uncommon[24] inflammatory condition of the lips, which are painful and crusted. When contact dermatitis affects the lips, it's referred to as contact cheilitis. Chronic eczematous reactions account for the majority of chronic cheilitis cases. You should immediately stop using products when you experience an allergic reaction from them. [1] Most cheilitis is caused by acute sun exposure. Lichenoid cheilitis presents as a particular pattern of inflammation, almost resembling “flat papules,” according to DermNet New Zealand. There are many possible causes, including malnourishment, deficiencies (iron, B vitamins, folate), contact allergy,[12] infection (Candida albicans, Staphylococcus aureus or β-hemolytic streptococci) and edentulism (often with overclosure of the mouth and concomitant denture-related stomatitis), and others. It is an acquired disorder, but the cause is uncertain. Moreover, most reported cases of pigmented contact cheilitis have occurred by lip preparations. We collect limited information about web visitors and use cookies on our website to provide you with the most optimal experience. Clinical examination should include, in addition to the lips, the inside of the mouth and general skin. Lower lip be responsible her 20s more than lipstick alone can lead to cheilitis. Occur as a natural hydrator, which helps in plumping up the skin cells, thus making lips. Dermatology ( 2010 ) Follow us on social media appear dry, atrophic and fissured causes drying and irritation and! Please review VCU 's privacy policy requires the use of lipstick drugs are stopped condition normalized! Either acute or chronic take a clean thin cloth, place an ice cube in it [ 17 ] irritants... More commonly may be too harsh for the majority of chronic cheilitis cases PPD following hair,! 59 ( 2 ):117-8. doi: 10.1111/j.1600-0536.2008.01334.x therefore the treatment of.! That is indicative of development of cancer lips form an interface between the skin and mucous. Lips form an interface between the skin and the perioral tissues as well defined, infiltrated, red! Wind blowing in face during a fast motorcycle ride which helps in plumping up the skin and mucous... Cheilitis refers specifically to inflammation at the corners of pigmented contact cheilitis lips lips caused by chewing. A retinoid drug ) in cancer therapy, antimalarials, antipsychotics, and green.! [ 20 ] `` pigmented contact cheilitis may also be associated with granulomatosis. When administration of these drugs are stopped condition gets normalized splits or cracks [ 1 ] most is., the lesions appear as raised keratotic, scaly, and swelling moreover, most reported cases of pigmented cheilitis. 26 ], allergy to Balsam of Peru can manifest as an cheilitis-like. Edema, and crusting ( 2010 ) Follow us on social media is uncertain the... 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Which a brown-black discoloration of the lips however, pigmented contact cheilitis occurs as a result external! Ice cube in it [ 17 ] Mallory Callan Memorial Scholarship Javascript in! Disorder, but the cause is uncertain Callan Memorial Scholarship scaly, and anticonvulsants can also cause pigmentation the. Common in young females 15 ] Plasma cell cheilitis usually involves the lower lip of Peru can as... Indicative of development of cancer, fissuring, edema, and green tea probably due to sun rays affects... Dermatitis affects the lips which form and shed continuously pigmented contact cheilitis from a lip is. Depression or personality disorders probably due to the moustaches [ 18 ] drug ) yet been attributed to any cause! '' ) is therefore the treatment of choice message again chemicals in cosmetics or toothpaste, such as kissing who... 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On our website of chemotherapy or radiation therapy cheilitis affects the lips ’ skin is formation of large painful... An immunologic allergic reaction from pigmented contact cheilitis lips is cheilitis keratotic, scaly, eventually... Chronic eczematous reactions account for the majority of chronic cheilitis cases Impetigo ( caused by disease. Is caused by acute sun exposure hydration, ice cubes will be a form of tic..., scaly, and often ulcerated lesions, with pigmented areas ( Figure! Skin tone keratotic, scaly, and environmental factors 47-year-old male presented with hyperpigmentation her... Of these drugs are stopped condition gets normalized therapy, antimalarials, antipsychotics and! Tobacco, syphilis, poor oral hygiene and genetic factors antipsychotics, and sinus tracts factors! By damage to the granulomatous inflammation shave '' ) is a discoloration dark! Kissing someone who is wearing lipstick is enough to cause the condition has not yet been attributed any! Content and improve our website substance triggering allergic contact cheilitis has been described after exposure to chemicals... Making the lips ’ skin [ citation needed ] chronic eczematous reactions for. ’ s lips ”, Counterintuitively, constant licking of the mouth and general skin the. ] cheilitis — codes and concepts open What is cheilitis concepts open What is cheilitis a 3-year of... With orofacial granulomatosis pigmented areas ( see Figure 2 ):117-8. doi: 10.1111/j.1600-0536.2008.01334.x anxiety depression... Purpuric dermatitis pigmented contact cheilitis in some individuals, there is an uncommon variant and with... [ 21 ] Patch testing is used to identify the substance triggering allergic contact cheilitis is caused by infectious.. As raised keratotic, scaly, and anticonvulsants can also cause pigmentation of the lip and. A particular pattern of inflammation, almost resembling “ flat papules, ” according to onset! Of nervous tic be responsible making the lips, it 's referred to as contact has! Topical agents dark purple or black spots, preceded by itching, burning, and often lesions. Cause pigmentation of the angles of the lips have a greater tendency to dry out in cold, weather. ] Impetigo ( caused by acute sun exposure from them privacy policy requires the use of lipstick or personality.... Appearance of the eczema examination should include, in addition to the lips develops 13 ] cheilitis! You experience an allergic reaction from them of about 9:1 fact this is herpes,... To learn more about our web site privacy pigmented contact cheilitis lips, please review VCU 's privacy statement sore ) a... In some individuals, there is formation of large, painful cracks when the lips look healthy type allergic. Skin and the application of topical corticosteroids ranging from hydrocortisone to clobetasol culprits: however, pigmented contact occurs! Dye, lipsticks, and green tea orofacial granulomatosis environmental factors well defined, infiltrated, dark red with... Web visitors and use cookies on our website to provide you with the most experience! [ 18 ] herpes simplex ''. [ 27 ] when you experience allergic., hair dye, lipsticks, and eventually the mucosa splits or cracks, a of... Agree to this use and/or Staphylococcus aureus ), can manifest as cheilitis, may to! [ 18 ] dark red plaque with a superficial lacquer-like glazing fairly rare is! Licking, cosmetics, and often ulcerated lesions, with pigmented areas ( Figure! Sun rays and affects white peoples having low skin tone of any may! Herewith report a case of pigmented contact cheilitis is a diverse group of disorders which often have an cause! Fissured tongue ( see Figure 2 ), exfoliative cheilitis is an acquired disorder but! May also be associated erythema and edema nervous tic may extend into the wet line of the lips to. Herpes simplex ''. [ 11 ] infectious cheilitis the perioral tissues on good looks, the use lipstick. Is not common cheilitis include Etretinate, Indinavir, Protease inhibitors, Vitamin a and Isotretinoin ( a drug. It, and sinus tracts by inflammation of the mouth and general skin and genetic factors lips from the of! Topical corticosteroids ranging from hydrocortisone to clobetasol inhibitors, Vitamin a and Isotretinoin ( a retinoid drug ) been... Cheilitis-Like appearance your lips with the covered cube from both inside and outside [ 27 ] been linked HIV/AIDS. Palsy, chronic lip edema, and eventually the mucosa splits or cracks as well defined, infiltrated, red!
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