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Cheilitis - Oral Mucosal Lesion
Other Resources UpToDate PubMed

Cheilitis - Oral Mucosal Lesion

Contributors: Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
Other Resources UpToDate PubMed

Synopsis

Lips of patients with cheilitis appear dry and scaly and may have one or more fissures. Often the lips are painful, and there may or may not be associated edema and erythema.

Cheilitis is one of the more challenging oral problems to diagnose and treat. Many cases represent a factitial disorder related to lip-licking habits, and it can be difficult to convince patients that the vermilion zone of the lip should be dry (the "wet line" is the demarcation between the labial mucosa and vermilion zone).

Some cases of cheilitis are related to contact hypersensitivity reactions to compounds found in products that commonly come into contact with the vermilion zone of the lip, including cosmetics, lip balms, toothpastes, and sunscreens (oxybenzone [benzophenone-3]).

Other cases of cheilitis are due to candidal infection related to chronic lip-licking or to the use of petrolatum-based materials that are applied to the lips. The petrolatum seals in moisture, allowing the candidal organism to thrive in the moist keratin that results.

Retinoids (isotretinoin and acitretin) are also frequent causes for this problem. High doses of vitamin A, lithium, chemotherapeutic agents (busulfan and actinomycin), d-penicillamine, isoniazid, and phenothiazine have also been reported to cause cheilitis.

Related topics: actinic cheilitis, angular cheilitis, exfoliative cheilitis

Codes

ICD10CM:
K13.0 – Diseases of lips

SNOMEDCT:
7847004 – Cheilitis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Actinic cheilitis
  • Allergic contact dermatitis
  • Lip-licking dermatitis
  • Chronic Oral candidiasis – Related to application of petrolatum-based lip balms.
  • Melkersson-Rosenthal syndrome / Melkersson-Rosenthal disease
  • Cheilitis glandularis – Very rare condition that is characterized by prominent swelling with eversion of the lip. Sometimes purulent exudate can be expressed from the minor salivary gland orifices on the labial mucosa.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:09/11/2023
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Patient Information for Cheilitis - Oral Mucosal Lesion
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Cheilitis - Oral Mucosal Lesion
A medical illustration showing key findings of Cheilitis : Erythema, Lip scaling, Lips
Clinical image of Cheilitis - imageId=2817180. Click to open in gallery.  caption: 'Cracked, eroded, and crusted plaques on the lips.'
Cracked, eroded, and crusted plaques on the lips.
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