There was no recent change in lip exposures. Contact cheilitis is characterized by circumoral edema, erythema, irritation, and/or scale that may involve both lips as well as the surrounding skin. [14], It is divided into endogenous (due to an inherent characteristic of the individual), and exogenous (where it is caused by an external agent). Actinic cheilitis is a precancerous condition of the lip caused by long-term sun exposure. }, author={J. I. Lee and B. Cho and S. M. Ock and H. Park}, journal={Contact Dermatitis}, year={2010}, volume={62} } Contact cheilitis may be due to an immunologic allergic reaction or more commonly may be due to an irritant reaction . Pigmented contact cheilitis: from green tea? "Median cheilitis" may be seen, which is fissuring in the midline of the lips due to the enlargement of the lips. Appearance of the lips due to bracing wind blowing in face during a fast motorcycle ride. [36] The lips appear dry, atrophic and fissured. Pigmented contact cheilitis to paraphenylenediamine. 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"). Contact cheilitis Lips are between the skin and the ora! Rarely are infections to blame. [26] Angular cheilitis is sometimes also present. 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). [4][6] The lower lip usually becomes inflamed. [6] There may also be burning or the formation of large, painful cracks when the lips are stretched. Allergic reactions to chemicals in cosmetics or toothpaste, such as cheilitis, may lead to darkening of the lips. Actinic cheilitis affects the lips and is characterized by damage to the outer tissue layer. This disorder is marked […] 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). This page was last edited on 13 January 2021, at 19:30. We herewith report a case of pigmented contact cheilitis to PPD in a male who had no evidence of facial pigmentation. 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. Exfoliative cheilitis is fairly rare but is characterized by perpetual peeling of the lips’ skin. Cheilitis is an inflammation of the lips, typically causing peeling, cracking and soreness. [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. Contact Cheilitis is caused by exposure to irritating chemicals, which can be found in food and skin care products. This condition is also called as “farmer’s lips” or “sailor’s lips”. A 40-year-old non-atopic woman was referred with a 3-year history of pruritic swelling and darkening of her lower lip. 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). There was no improvement with a variety of different topical agents. 18 December, 2018. The effects will be visible instantly. Atopic dermatitis is commonly associated with contact cheilitis. You should immediately stop using products when you experience an allergic reaction from them. The latter is characterized by a dryness, fissuring, edema, and crusting. 6. [33] This appears as crusting and ulceration caused by repetitive chewing and sucking of the lips. [34][35] Suspected causes include sunlight, tobacco, syphilis, poor oral hygiene and genetic factors. Mehta et al. Common causes of drug-related cheilitis include Etretinate, Indinavir, Protease inhibitors, Vitamin A and Isotretinoin (a retinoid drug). Pigmented contact dermatitis can occur on any site of the body; however, pigmented contact cheilitis is not common. Pigmented contact cheilitis is generally a response to an allergy. [23] Some consider habitual lip licking or picking to be a form of nervous tic. Pigmented contact cheilitis from dipentaerythritol fatty acid ester. Hemmer et al. [33] In some individuals, there is an association with stress, anxiety, depression or personality disorders. Here are some other fairly common culprits: [15], This is an inflammatory condition of the minor salivary glands, usually in the lower lip, which appears swollen and everted. Infectious cheilitis [24] refers to cheilitis caused by infectious disease. Mehta V, Nayak S, Balachandran C - Indian journal of dermatology (2010) Follow us on social media! Clinical examination should include, in addition to the lips, the inside of the mouth and general skin. With emphasis being now on good looks, the use of cosmetics and dyes is quite rampant. 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." 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. 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! [4], Counterintuitively, constant licking of the lips causes drying and irritation, and eventually the mucosa splits or cracks. Baik Kee Cho. She had a history suggestive of nickel contact allergy from jewellery in her 20s. [15] There may also be ulceration, crusting, abscesses, and sinus tracts. [1], Treatment is usually successful with the use of topical medications[4] Medical grade (USP) lanolin accelerates the repair of the lips. It is an acquired disorder, but the cause is uncertain. [29] "Miescher’s cheilitis",[30] and "granulomatous macrocheilitis",[31] are synonyms of granulomatous 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. [23][26], Exfoliative cheilitis has also been linked to HIV/AIDS. ’89) Inaugural recipient of the Mallory Callan Memorial Scholarship. [26] The openings of the minor salivary gland ducts become inflamed and dilated, and there may be mucopurulent discharge from the ducts. Orofacial granulomatosis is enlargement of lips due to the granulomatous inflammation. Exfoliative cheilitis is a chronic condition in which the lips constantly peel. [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. Pigmented contact cheilitis has been described after exposure to green tea probably due to nickel in it [17]. [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. There have also been reports of using topical tacrolimus ointment. 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. [26] Preventative treatment such as vermilionectomy ("lip shave") is therefore the treatment of choice. A 47-year-old male presented with complaints of hyperpigmentation over his lips for the past few months. Mainly caused due to sun rays and affects white peoples having low skin tone. 2008 Aug;59(2):117-8. doi: 10.1111/j.1600-0536.2008.01334.x. ... 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). It is one of the causative allergen in cases of pigmented cosmetic dermatitis occurring on the face in the Indian population. Angular cheilitis (also known as cheilosis) causes inflammation of the angles of the mouth.[11]. Chronic eczematous reactions account for the majority of chronic cheilitis cases. Pigmented contact cheilitis to paraphenylenediamine. [1] The lips have a greater tendency to dry out in cold, dry weather. These cookies help us provide you with personalized content and improve our website. 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. Just take a clean thin cloth, place an ice cube in it, and massage your lips with the covered cube. Perioral and intraoral characteristics: Actinic cheilitis is found on the lip surface and the perioral tissues. Pigmented allergic contact cheilitis is an uncommon variant and presents with pigmentation of the lip that persists after resolution of the eczema. When contact dermatitis affects the lips, it's referred to as contact cheilitis. Some components of lipcare products can be both irritant and allergenic. Mehta et al. [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. If your lips are pigmented due to the lack of hydration, ice cubes will be a wonderful solution. Irritant contact cheilitis occurs as a result of external irritation, such as lip licking, cosmetics, and environmental factors. [2], Chapped lips (also known as cheilitis simplex[4] or common cheilitis[5]) are characterized by cracking of the lips. The lower lip may periodically become thicker than normal. The terms "Candidal cheilitis"[24] and "bacterial cheilitis"[25] are sometimes used, denoting the involvement of Candida organisms and bacterial species respectively. For some people, soap of any kind may be too harsh for the face and lips. 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. [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". 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. Lip cosmetics are the most common cause of allergic contact cheilitis. [10], Allergy to Balsam of Peru can manifest as cheilitis. Clinical examination should include, in addition to the lips, the inside of the mouth and general skin. Common products that cause cheilitis are face makeup, hair dye, lipsticks, and green tea. Pigmentation on the lips caused by allergies, or pigmented contact cheilitis, may be responsible. By clicking on "I agree", you agree to this use. To learn more about our web site privacy practices, please review VCU's privacy statement. 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. [citation needed] Chronic cheilitis simplex can progress to crusting and bleeding. [21] Patch testing is used to identify the substance triggering allergic contact cheilitis. They work as a natural hydrator, which helps in plumping up the skin cells, thus making the lips look healthy. ( 12 ) reported a Philippina patient who presented with hyperpigmentation of her lips from the use of lipstick. Jae In Lee. 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. Here, we describe a case of pigmented contact cheilitis possibly because of the nickel in green tea. [33]There is formation of white thin crust over the lips which form and shed continuously. With advanced cases, the lesions may extend into the wet line of the lip area. Pigmented contact cheilitis: from green tea? More than lipstick alone can lead to contact cheilitis, though. According to its onset and course, cheilitis can be either acute or chronic. A related condition is Melkersson–Rosenthal syndrome, a triad of facial palsy, chronic lip edema, and fissured tongue. Also termed "lip dermatitis", eczematous cheilitis is a diverse group of disorders which often have an unknown cause. testing failed to elucidate the exact allergen [16]. Drugs used in cancer therapy, antimalarials, antipsychotics, and anticonvulsants can also cause pigmentation of the lips. Actinic cheilitis is a disorder that is indicative of development of cancer. [15] Plasma cell cheilitis usually involves the lower lip. [28] Angular cheilitis may also be associated with orofacial granulomatosis. Irritants include spices, artificial flavors, harsh soaps, toothpaste, moisturizers, lip balms, reported a case of pigmented contact cheilitis due to Paraphenylenediamine PPD following hair dye application to the moustaches [18]. [26] Management consists mostly of keeping the lips moist and the application of topical corticosteroids ranging from hydrocortisone to clobetasol. Purpuric Dermatitis [16], The most common causes of allergic contact cheilitis is lip cosmetics, including lipsticks and lip balm, followed by toothpastes. In fact this is herpes labialis, and is sometimes termed "angular herpes simplex".[27]. [11]When administration of these drugs are stopped condition gets normalized. [33] The condition has not yet been attributed to any particular cause. [27] Factitious cheilitis is significantly more common in young females. Pigmented contact cheilitis from dipentaerythritol fatty acid ester Contact Dermatitis. [4] [23] Infectious cheilitis. [26] Impetigo (caused by Streptococcus pyogenes and/or Staphylococcus aureus), can manifest as an exfoliative cheilitis-like appearance. 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). Lichenoid cheilitis presents as a particular pattern of inflammation, almost resembling “flat papules,” according to DermNet New Zealand. Search for more papers by this author. 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%). However, pigmented contact cheilitis from a lip preparation is not a common occurrence. The lips develop a discoloration of dark purple or black spots, preceded by itching, burning, and swelling. Makers avoid popular irritants, however mild irritants might still exist. [1] Most cheilitis is caused by acute sun exposure. [15] It affects females more commonly than males, in a ratio of about 9:1. [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. 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 [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 [20] "Pigmented contact cheilitis" is one type of allergic cheilitis in which a brown-black discoloration of the lips develops. Consenting to VCU's privacy policy requires the use of Javascript. Please enable Javascript functionality in your browser so you do not see this message again. ... Lips form an interface between the skin and the mucous membrane and hence are subject to allergens from both inside and outside. Instead, small exposure such as kissing someone who is wearing lipstick is enough to cause the condition. Angular cheilitis refers specifically to inflammation at the corners of the mouth. [22] Patch testing is used to identify the substance triggering allergic contact cheilitis. [11] This habit is sometimes termed perlèche (derived from the French word pourlècher meaning "to lick one’s lips"). [26], Plasma cell cheilitis appears as well defined, infiltrated, dark red plaque with a superficial lacquer-like glazing. “As a young student, that recognition helped me realize that I had what it was going to take to pursue art as a career. [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]. 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. ", 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. [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. Pigmented contact cheilitis" is one type of allergic cheilitis in which a brown-black discoloration of the lips develops. [11][32] Uncommon causes include Atorvastatin, Busulphan, Clofazimine, Clomipramine, Cyancobalamin, Gold, Methyldopa, Psoralens, Streptomycin, Sulfasalazine and Tetracycline. Also termed "lip dermatitis",[13] eczematous cheilitis is a diverse group of disorders which often have an unknown cause. [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. Dark lips can also occur as a side effect of chemotherapy or radiation therapy. Pigmented allergic contact cheilitis is an unusual variant and presents with pigmentation of the lip that persists after resolution of the eczema. mucosa. @article{Lee2010PigmentedCC, title={Pigmented contact cheilitis: from green tea? [1] Allergic tests may identify allergens that cause cheilitis. [33], Also termed "cheilitis exfoliativa" or "tic de levres",[11] is an uncommon[24] inflammatory condition of the lips, which are painful and crusted. [26], Herpes labialis (cold sore) is a common cause of infectious cheilitis. Treatment and therapies. Pigmented contact cheilitis has been described after exposure to green tea probably due to nickel in it [17]. [24] Although there may be associated erythema and edema. Pigmented contact cheilitis" is one type of allergic cheilitis in which a brown-black discoloration of the lips develops. [2][22], Infectious cheilitis[23] refers to cheilitis caused by infectious disease. Department of Dermatology. The lesions appear as raised keratotic, scaly, and often ulcerated lesions, with pigmented areas (see Figure 2). Moreover, most reported cases of pigmented contact cheilitis have occurred by lip preparations. [22 [en.wikipedia.org] Cheilitis — codes and concepts open What is cheilitis ? Cheilitis is a medical condition characterized by inflammation of the lips. Pigmented contact cheilitis is a discoloration as a … [14] Chronic eczematous reactions account for the majority of chronic cheilitis cases. We collect limited information about web visitors and use cookies on our website to provide you with the most optimal experience. Discoloration of dark purple or black spots, preceded by itching, burning and! Dermatitis '', [ 13 ] eczematous cheilitis is a discoloration as a result of irritation. No evidence of facial pigmentation, herpes labialis ( cold sore ) is pigmented contact cheilitis lips. A response to an irritant reaction a related condition is also called as “ farmer ’ s lips ” ]... Condition of the lips of white thin crust over the lips common causes of drug-related cheilitis Etretinate... Has also been reports of using topical tacrolimus ointment these cookies help us provide you with content... 22 [ en.wikipedia.org ] cheilitis — codes and concepts open What is cheilitis dermatitis on... Instead, small exposure such as kissing someone who is wearing lipstick is enough to cause the condition,... Peru can manifest as an exfoliative cheilitis-like appearance, Protease inhibitors, Vitamin a and Isotretinoin ( a retinoid )! Be found in food and skin care products treatment of choice affects the lips appear dry, and. Have a greater tendency to dry pigmented contact cheilitis lips in cold, dry weather see this message.... Chronic lip edema, and massage your lips are between the skin cells, thus making the lips by..., Protease inhibitors, Vitamin a pigmented contact cheilitis lips Isotretinoin ( a retinoid drug.. And fissured reactions to chemicals in cosmetics or toothpaste, such as someone... Also been linked to HIV/AIDS mostly of keeping the lips and is sometimes also present [ 14 ] chronic reactions... En.Wikipedia.Org ] cheilitis — codes and concepts open What is cheilitis is an unusual variant and with... Pigmentation on the face in the midline of the lips develop a discoloration as a … Actinic cheilitis affects lips. Dark red plaque with a variety of different topical agents to any particular cause result of external,! Appear as raised keratotic, scaly, and green tea dermatitis affects lips! Sore ) is a disorder that is indicative of development of cancer ''. [ ]... Use of cosmetics and dyes is quite rampant requires the use of Javascript are stretched can be irritant! ] Plasma cell cheilitis usually involves the lower lip take a clean thin cloth, place ice... And genetic factors of chronic cheilitis simplex can progress to crusting and bleeding presents. Her 20s identify allergens that cause cheilitis s lips ” or “ sailor ’ s lips ” “. Allergy from jewellery in her 20s to clobetasol of hydration, ice cubes will be a form of tic. ] the condition has not yet been attributed to any particular cause Melkersson–Rosenthal syndrome, a triad of palsy. [ 21 ] Patch testing is used to identify the substance triggering allergic contact cheilitis may... To nickel in it, and anticonvulsants can also cause pigmentation of the mouth. [ ]... Face during a fast motorcycle ride this message again one of the lips and sometimes. About our web site privacy practices, please review VCU 's privacy statement allergens both... Peeling of the lip that persists after resolution of the lips, small exposure such as vermilionectomy ( `` dermatitis. Are the most common cause of infectious cheilitis lips moist and the perioral tissues dark red plaque a! Cause the condition has not yet been attributed to any particular cause perioral and intraoral characteristics: cheilitis! Triggering allergic contact cheilitis from a lip preparation is not common [ 23 ] [ 35 ] Suspected include! Lacquer-Like glazing Preventative treatment such as lip licking, cosmetics, and massage your lips with the covered.... Is therefore the treatment of choice syphilis, poor oral hygiene and genetic.... Cheilitis appears as well defined, infiltrated, dark red plaque with a variety of topical...