This document discusses various diseases that can affect the lips. It describes conditions like angular cheilitis, lip fissures, allergic cheilitis, actinic cheilitis, exfoliative cheilitis, perioral dermatitis, lick eczema, and cheilocandidiosis. For each condition, it covers causes, symptoms, diagnosis, and management approaches. The document is intended to describe the different lip diseases that can occur so the reader understands which conditions to consider based on a patient's presentation.
3. Learning Outcomes?
At the End oF this Discussion we will be able to Describe
Which are the Diseases Of the Lips??
1. Swelling?
Generalized
Localized
1. Angular Cheilitis?
2. Lip Fissures?
3. Allergic Cheilitis?
4. Actinic cheilitis?
5. Exfoliative
6. Perioral Dermatitis?
7. Lick Eczema?
8. Cheilocandidiosis
4. Swelling Of Lips?
Swelling of lips
It May be
1. Generalized/Diffuse
2. Localized
Usually involves Perioral area of skin
Usually patients of Orofacial Granulomatosis and
angioedema present with lip swelling.
9. Angular Cheilitis
Angular Chelitis is the Inflammation of one or both
corners of mouth
Multifactorial disease
with
1. Local
2. Systemic factors
10. Inadequate
Dentures
• Skin creasing with sliva
leakage and maceration
at corners of the mouth
• Host Defences
Compromised
Systemic
Diseases or
Deficiencies
• Anemia
• Iron Deficiency, B12 or
Folate Deficiency
• HIV
• Diabetes Mallitus
• Sjogresn’s Syndrome
Trauma
• S. Aureus Species
• Candida Species
11. Diagnosis?
1. Complete Medical, social, Dental History
2. Complete Examinations Especially for anemia, ill
fitting denture, denture and candidial infections.
3. Investigations?
1. Microbilogical:
1. Sampling? Smear, swab, oral rinse
2. Site? Angle, palate, fitting surface of denture
Blood Tests:
Complete Blood Count
Serum B12, ferritin, serum and red cell folate levels
12. Management
Elimination of local factors
Denture Hygiene
Instruct patient to leave denture at night
Referral to medical specialist for underlying medical
cause
Provision of antimicrobial therapy
1. Local
2. Systemic
14. Lip Fissures
Less common
Midline of lower lip
Resistant to conservative treatment usually
Majority of these is due to Infections which may be
S.aureus or candida albicans
Treatment principle is based on elimination of secondary
cause of infection and then topical steroid Creams
application.
Recurrence is common
Commonly seen in patients of down syndrome along with
angular cheilitis as well as OFG
15.
16. Allergic Chelitis
Irritation and scaling of lips caused by allergy due to
1. Lipsticks
2. Ointments
3. Foods
4. Moisturizes
5. Tooth pastes
6. Lipstick allergy may also be caused by straw sharing and
kissing
Mangement:
1. Identification and removal of the cause of irritation
2. Topical steroids cream can be used for short term
management
17.
18. Actinic Cheilitis
Solar keratosis
predominantly male patients
Prolonged exposure to sunlight either occupational or
recreational may result this
Long exposure to sunlight
Lower lip more effected
Crusting and induration of the vermilion margin
May progress to carcinoma
Biopsy is necessary for complete assessment
19. Epithelial atypia is seen in this condition
Crusting and induration is due to fibrotic reaction of
the connective tissues.
Treatment :
1. Excision by either lip shave operation
2. laser treatment
20. Exfoliative Chelitis
Production of excess amount of keratin
Involves vermilion border
Brown scales are formed which may be removed by the patient or
may persist
Reported to be exclusively in females
Histology is simply hyperparakeratosis
Not a malignant condition
May be related to stress, no definite cause is known
Various treatments have been used like local and systemic steroids,
cautery, cryosurgery and many others but all without success.
Antidepressants have also been used with some success reported.
Resolves itself usually.
21.
22. PeriOral Dermatitis
Relatively unommon
Young adult females
Erythematous rash on the facial skin around the
mouth
Can be due to previous use of steroid creams or contact
allergy
Clinical diagnosis
Treated with low potency steroid like 1%
hydrocortisone
More tan one aetiological factor may be involved.
23.
24. Lick Eczema
Young children
Sharply deliniated zone of irritable scaly skin around
the mouth
Treatment is to stop the habit of licking
Removable appliance
25.
26.
27. Cheilocandidosis
Heavy candidial infection
Bilaterally
Lower lip
Ulcerated granular areas
Generally healthy patients with a previous history of
local abnormality.
Early treatment with anti fungals is necessary.