Cheilitis is an isolated inflammatory process in the area of the mucous membrane, skin and red border of the lips. Outwardly it looks like swelling with redness and peeling of tissue. It can be an independent disease or a symptomatic manifestation of other pathologies. Sooner or later, almost every person encounters it, but at a young age the disease is noticeably milder, recurs less often and has no complications. In older people, due to a weakened immune system, periodic relapses of cheilitis can cause malignant tissue degeneration.
Reasons for the development of cheilitis
The main causes of the disease include:
- Dermatoses seem to be the most common cause of cheilitis. Skin diseases such as psoriasis, lupus erythematosus, syphilis, tuberculosis, lichen, also often provoke inflammation of the red border of the lips.
- Thyroid diseases.
- Allergies to various kinds of external factors, professional activities.
- Adverse weather conditions.
- Hereditary predisposition.
- Decreased immunity, gastrointestinal diseases.
Possible complications
Failure to see a doctor in a timely manner often causes serious complications. The disease itself often does not pose a serious health risk. But only an experienced specialist can tell you how to treat cheilitis. Self-medication can lead to unpleasant consequences and provoke the occurrence of a chronic form of the disease. In addition, cheilitis is dangerous because its symptoms can mask malignant tumor processes. It is important to remember that some forms are prone to malignancy - cheilitis may be followed by precancerous conditions.
Types of cheilitis
All types of cheilitis are divided into two groups:
- symptomatic (cheilitis, as a manifestation of the underlying disease);
- true (as an independent disease).
Types of symptomatic cheilitis and their clinical manifestations
The symptomatic group includes the following types of cheilitis:
- Eczematous - develops against the background of eczema, characterized by redness, swelling, burning and pathological changes in the skin of the lips. If left untreated, it becomes chronic.
- Macrocheilitis - this form of cheilitis is considered a component of Melkersson-Rossolimo-Rosenthal syndrome. There is severe itching and swelling of not only the lip, but also other parts of the face.
- Atopic - a predisposition to allergies to medications and food is a prerequisite for the development of inflammation. It manifests itself as peeling, redness, itching of the skin of the lips, and the formation of cracks in the corners of the mouth.
Diathesis and its causes
Atopic dermatitis (diathesis) is the most common allergic skin disease in children and adults, which is characterized by inflammation, itching, and a chronic relapsing course. Atopic dermatitis typically has different skin manifestations depending on the person's age. Let's look at it in more detail below.
Atopic dermatitis (diathesis) is the most common allergic skin disease.
Causes of diathesis
A special role in the development of the disease is played by the hereditary ability to develop allergic diseases.
The disease is also based on other causes, which can be divided into internal and external. Internal characteristics include the characteristics of the organism itself. External causes include those with which a person comes into contact from the outside.
Internal reasons
- Hereditary – determined ability of the body to increase the production of IgE (immunoglobulin, responsible in most cases for allergies).
- Increased, excessive reaction of the skin to irritants (allergens).
- Increased skin dryness.
- Violation of the epidermal barrier.
External reasons
- In children of the first years of life - food allergies, as well as intestinal dysbiosis, vaccination (DPT). It is important to emphasize that vaccination will not lead to the development of atopic dermatitis in every child. There is only a higher likelihood of developing this disease in children with a history of allergies.
- Preschool children have household and fungal allergens. Often the cause can be helminthiasis.
- In adolescence – stress, emotional experiences.
- The causes of diathesis in adults are a combination of the factors described above. This could be a food allergy, an allergy to flowering plants, a contact allergy (when allergens come into contact with the skin), stress, or emotional distress.
Types of true cheilitis
True cheilitis includes:
- Contact - manifests itself as a result of the body’s reaction to contact with an irritant: cosmetics (determined mainly in women), the bad habit of holding a pen or pencil in the mouth, professional activity (musicians due to prolonged use of the mouthpiece of a wind instrument) Characterized by redness, itching, feeling burning, swelling of the lips.
- Actinic - involves the development of an inflammatory process as a result of special sensitivity to natural phenomena: sunlight, wind, frost, radiation. It manifests itself as small blisters or erosion, swelling of the red border. This type of cheilitis is also called meteorological.
- Exfoliative - occurs mainly in women. The development of pathology occurs against the background of depression, anxiety, and various disorders of the nervous system. The main symptoms are dryness, severe, prolonged peeling of the lip border. Exfoliative cheilitis has two forms: dry and exudative. With exudative inflammation, crusts form, causing pain in the patient.
- Glandular - occurs against the background of hypertrophy of the minor salivary glands. This phenomenon can be congenital (appears after puberty) or acquired as a result of chronic inflammation. There is a risk of suffering from glandular cheilitis in people with periodontal disease, numerous carious cavities, after lupus erythematosus, and leukoplakia. It is initially characterized by increased dryness, which does not disappear with the use of hygiene products. Later - the presence of cracks due to the constant exposure of saliva to the red border of the lips. 20-30% of patients with glandular cheilitis develop squamous cell carcinoma. It is necessary to take a responsible approach to the treatment of this disease and seek qualified help from doctors in a timely manner - surgical intervention may be required.
Symptoms of diathesis in children and adults
Diathesis can appear at any age. The main manifestation is constant severe itching in combination with local skin manifestations . The disease is characterized by a relapsing course.
Diathesis can appear at any age.
The first signs of the disease appear at an early age. They are preceded by the appearance of scales on the scalp and eyebrows (gneiss). One of the main and main manifestations of dermatitis in young children is redness and dryness of the skin of the cheeks. A characteristic feature is that the nasolabial triangle and nose remain untouched by allergic rashes. If parents do not take any measures, the process progresses. Lesions also appear on other parts of the body: scalp, ears, torso, extensor surfaces of the limbs. Often the rash can be located on the buttocks, around the anus. Without treatment, the process progresses, and small blisters appear against the background of redness and swelling of the skin, which quickly collapse. As a result, wounds appear that become covered with crust and scales. After peeling off the crusts, smooth, bright pink skin remains at the affected areas. Sometimes, against the background of the described rash, small nodules may also appear on the skin, which rise above the skin level. on the skin are usually located symmetrically .
With age, many patients experience clinical transformation of skin rashes. In adults they look different and are located in different places. The lesions look like thickened and dry skin. They are located on the neck, elbow and popliteal folds, on the back of the hands, in the axillary and inguinal folds, sometimes around the mouth, eyes and in the genital area. Characterized by intense itching of the skin, which intensifies at night. Because of this, sleep is disturbed, the person becomes irritable and moody. Constant itching leads to the fact that a child or adult scratches dry areas of the skin and a wound surface appears that becomes covered with crusts.
Treatment of cheilitis
This disease requires special treatment, depending on the cause, type and degree of the inflammatory process. The main methods of treating cheilitis:
- local treatment of the surface of the skin of the lips with disinfectant solutions, ointments, vitamin oil solutions;
- physiotherapeutic methods: Bucca radiation, ultrasound, laser therapy;
- a course of vitamin therapy;
- rinsing the mouth with decoctions of medicinal herbs.
If necessary, to eliminate the causes of the disease, specialized specialists may be involved: a dermatologist, an allergist, an infectious disease specialist.
Diagnostic features
If inflammation appears on the lip, it is advisable to visit a therapist, for children a pediatrician, if indicated, an infectious disease specialist, a dentist, or other specialized specialists. Diagnosing cheilitis is usually not difficult - a specialist will conduct an examination, listen to complaints and prescribe a series of tests. If the allergic nature of the disease is suspected, allergy tests may be recommended, and if plaque appears, it is advisable to take a scraping. To detect endocrine and other disorders that may cause the disease, biochemical blood tests and other diagnostic methods are often prescribed. In rare cases, a biopsy is required to differentiate cheilitis from other pathologies. This will help to exclude the malignant or precancerous nature of inflammatory formations and prescribe the correct treatment.
Allergic cheilitis
A disease that develops in allergy sufferers upon contact with an allergen and affects the surface of the lips. Typical manifestations of this type of cheilitis are a feeling of itching and burning on the lips, dryness and significant discomfort. The lips begin to dry and peel, and the scales of dead epithelium begin to flake off.
The main cause of this disease is the patient’s increased sensitivity to external irritants, in particular to allergens. Allergic, or, as it is also called, contact cheilitis can develop gradually.
It all depends on the patient’s personal sensitivity to allergens, and it can develop over several weeks, months and even years. The duration of this process is determined by the peculiarities of the endocrine system, as well as the degree of manifestation of allergic reactions.
This disease practically does not appear in children. According to statistics, most patients with allergic cheilitis are women over twenty years of age.
Causes of the disease
In most cases, allergic cheilitis is caused by contact allergic irritants. Among the most common allergens that cause cheilitis is lipstick. It is not the lipstick itself that is dangerous, but the substances it contains - rhodamine, eosin and others. Provoking factors also include low-quality dental implants and plastic dentures.
Allergic manifestations may appear after contact with citrus fruits, as well as in patients who have the habit of chewing pencils or pens. The disease is also common for those whose work involves playing wind instruments or hazardous chemical production.
Symptoms of the disease
The disease manifests itself as hyperemia and swelling of the lips, as well as a sensation of itching and burning, accompanied by the formation of erythema. Small painful blisters appear and burst on the affected areas of the lips. If the pathogenic process is prolonged, over time, small scars and scars will form in their place on the lips. Dry lips only increase over time.
Inflammation almost never extends beyond the red border around the lips. In rare cases, it may spread to adjacent skin. Sometimes the inflammatory process moves to the oral mucosa. This form of allergic cheilitis is characterized by hyperemia (significant redness of the tissues), the appearance of noticeable swelling of the tissues, and when trying to palpate, pain occurs.
Diagnosis and treatment
Diagnosis of the disease is carried out by a dentist together with an allergist. To determine the allergen, it is necessary to conduct allergy tests.
When making a diagnosis, it is important to distinguish allergic and atopic cheilitis, as well as exclude exfoliative and actinic cheilitis. Treatment of this disease includes the mandatory elimination of the irritant or allergen that caused it.
Systemic (general) and topical (local) drug therapy is used. General therapy refers to the use of medications taken orally. To relieve allergy symptoms, a course of antihistamines is used. If the case is sufficiently complex, the use of corticosteroids may be indicated. In addition, calcium supplements may be prescribed.
Local treatment of allergic cheilitis includes the use of a variety of emollient oils, ointments and balms based on sea buckthorn, vitamin E and others. To avoid the recurrence of the pathology, it is necessary to take an allergy test in order to eliminate any contact with the allergen in the future. It is also advisable to reconsider your diet and carefully consider the choice of cosmetics.
Prognosis and prevention
With timely treatment and the absence of malignancy processes, the prognosis is almost always favorable. If the therapy has caused noticeable cosmetic defects, you can resort to methods for correcting the appearance of the lips.
To prevent complications, it is important to understand whether you are at risk. The presence of allergic diseases and dermatoses, chronic endocrine diseases, and wearing dentures increase the risk of developing pathology. To prevent the appearance of cheilitis, it is important to adhere to several rules:
- regularly visit the dentist, sanitize the oral cavity, remove tartar;
- promptly replace outdated fillings and orthopedic structures, contact after chipped teeth and injuries to prevent lip injury from the sharp edges of fillings and enamel;
- For the manufacture of prostheses, contact only professionals;
- eat properly and nutritiously to prevent hypovitaminosis;
- try to avoid prolonged exposure to the sun and use products with SPF, including for lips;
- be attentive to your health and promptly treat diseases of the gastrointestinal tract, endocrine, nervous system, and internal organs.
