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