Cheilitis is an inflammation of the red border, mucous membrane and skin of the lips. In common parlance, the disease is called jamming. The inflammatory process can be long-lasting and periodically worsen. In healthy young people it often goes away on its own, but in children, the elderly and people with chronic diseases it should be treated with medication. Elderly people have a high risk of leukoplakia and malignancy of the process.
Cheilitis is treated by a dentist, and if necessary, a therapist, pediatrician and other specialized specialists - an endocrinologist, an infectious disease specialist, etc. - are involved in drawing up a treatment plan.
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.
Atopic
This disease is one of the symptomatic manifestations of atopic dermatitis. Characteristic signs are redness, slight swelling, itching, peeling of the skin in the red border area, as well as the spread of the inflammatory process to the corners of the lips, where cracks often form.
The cause is considered to be genetic abnormalities and poor heredity. By puberty, atopic cheilitis can heal itself or go into remission, but recurrent seasonal lesions cannot be ruled out. Allergens can be food, cosmetics, medications and many other factors.
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.
Diagnostics
In the process of diagnosing this disease, the key task of a specialist is to differentiate exfoliative cheilitis from other diseases that are similar in external manifestations.
Thus, the dry form of cheilitis in the diagnostic process is compared with the following diseases:
- meteorological cheilitis,
- atopic cheilitis,
- contact allergic cheilitis.
The exudative form requires differentiation with the following diseases:
- exudative form of actinic cheilitis;
- eczematous cheilitis;
- erosive-ulcerative form of lupus erythematosus.
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.
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.
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.
Chronic
The presence of chronic cheilitis in a patient indicates that at one time, due attention was not paid to the treatment of the acute form. The development of this form can also be caused by previous infectious diseases caused by yeast infections, streptococci and staphylococci, as well as injuries or hormonal imbalances.
Treatment of the chronic form of the disease is determined based on the cause of its formation. Types such as Miescher granulomatous cheilitis, streptococcal, glandular and meteorological cheilitis can become chronic.
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.
ICD-10
In medicine, a group of diseases of the lip mucosa is designated by a special code - K13.0 .
The classification defines these pathologies as diseases of a benign nature with diverse causes of their occurrence.
The section includes a number of diseases: abscess, fistula, cellulite of the lips, their jams, cracks, hypertrophy and the main forms of cheilitis and cheilosis, which arise as independent pathologies and as a symptom of underlying diseases. Their nature can be different, both inflammatory and degenerative.
Fungal infections of the lips are excluded from this subgroup; they are classified in heading B37.83. Separately, this official document highlights cheilosis due to vitamin A hypovitaminosis (E53.0) and allergic cheilitis, included in block L20-L30.
Cheilitis on the lips: photo
Varieties of cheilitis in medicine are grouped by doctors into subgroups according to certain characteristics:
1. According to the speed and characteristics of the process (acute, chronic, latent, in the acute phase).
2. By origin: cheilitis itself (actinic, meteorological, allergic, etc.) or symptomatic (atopic; lip eczema, Melkersson-Rosenthal syndrome, etc.).
