Not heard of: Exfoliative cheilitis is rather rare, and has other causes, if suspected, better see a dermatologist for proper management, best wishes Send thanks to the doctor A 16-year-old male asked: Dermatology. Moisturizing and use of lip balms is encouraged but results are varied. The latter is characterized by a … The peeling associated with exfoliative cheilitis is often involuntary and can be … USA.gov. Avoid licking the lips as saliva evaporates quickly resulting in them being drier than before. It involves constant shedding of the skin of the lips. The most common of these are psoriasis, atopic dermatitis, seborrheic dermatitis, contact dermatitis and pityriasis rubra pilaris. -, Factitious cheilitis. 1981;117:338–340. When your lips are this broken-down, they just can’t get over the hump to heal themselves if they’re being accosted with more allergens, even natural stuff like beeswax and essential oils. 1995;24:177–179. There is formation of white thin crust over the lips which form and shed continuously. Affe … National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Skin biopsy is not necessary or helpful for this diagnosis. A. It predominantly affects both sexes under 30 years of age and typically follows a cyclical course. © 2021 Academic Dermatology of Nevada. Exfoliate Cheilitis (EC) is a rare chronic localized in- flammatory condition of the vermillion border, which is characterized by the regular shedding of surface keratin layer. Regional atlas of contact dermatitis mouth lips and peri region the dermatologist regional atlas of contact dermatitis mouth lips and peri region the dermatologist lip eczema physical findings dermatology education.  |  The patients develop an exfoliative dermatitis with sharp margins that rims the upper and lower lips…often looking like a clown face as shown in the picture above and below. Affected areas can progress to superinfection with Staphylococcus aureus or Candida albicans. Cheilitis, or "lip inflammation," is a condition that manifests as red, dry, scaling, and itchy lips. Occasionally, due to tissue breakdown, secondary infections may occur requiring use of topical and at times oral antibiotics. a French dermatologist, in the 19th [1]century. Exfoliative Cheilitis as a Manifestation of Factitial Cheilitis. Exfoliative cheilitis: a case report and review of the literature. This field is for validation purposes and should be left unchanged. Thick yellow crust on the bilateral upper and lower lips with edematous change, erosions, and tenderness to palpation. Exfoliative cheilitis is a progressive skin disorder that affects the lips. Causing inflamed lips, exfoliative cheilitis is also characterized by rapid and continuous peeling of the lips. Exfoliative cheilitis. Exfoliative cheilitis is a rare type of chronic lip inflammation. Although there may be associated erythema and edema. -, Exfoliative cheilitis. Cheilitis, exfoliative Cheilitis, foreign body Cheilitis, glandular Cheilitis, granulomatous Cheilitis, infective Cheilitis, plasma cell ... Rook's Textbook of Dermatology is the most comprehensive work of reference available to the dermatologist. Depression and personality disorders have been reported to be associated with Exfoliative Cheilitis. I have all the symptoms of Exfoliative Cheilitis with a non-stop cycle of my lips peeling and then being raw. Clinical and histologic correlation of two separate biopsies plus a negative infectious workup led to the consideration of a factitial etiology. Dermatologic disorders occasionally present as exfoliative dermatitis. Exfoliative type: Infection, pain, and crusting occur at the vermilion zone of the lips. It remains largely refractory to treatment, including corticosteroid therapy, antibiotics, antifungals, and immunosuppressants. 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. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Exfoliative cheilitis and eyelid dermatitis are two conditions that require the barrier and hypoallergenic properties of petroleum jelly to begin the healing process. Daley TD, Gupta AK. Through open and direct communication between the patient and the provider, the appropriate diagnosis was discerned. Factitial cheilitis can present as exfoliative cheilitis when it is due to attention-seeking or factitial behaviour or an obsessive - compulsive tendency to pick or chap the lips (exfoliative). Cheilitis(Inflammation of the skin on and around the lips)is often seen in atopic dermatitis. Clipboard, Search History, and several other advanced features are temporarily unavailable. Aydin E, Gokoglu O, Ozcurumez G, Aydin H. J Med Case Rep. 2008 Jan 29;2:29. doi: 10.1186/1752-1947-2-29. Less pronounced forms may be seen in lip sucking, lip picking, lip biting and in patients that are mouth breathers. Chronic Lip Licking is often seen in children and is also referred to as Exfoliative Cheilitis, or Cheilitis Exfoliativa . Drink plenty of water and take multivitamin supplements and do not apply lipstick or other cosmetic products for some days. Thick brown scales of keratin are peeled off from the site of infection. Exfoliative cheilitis is a rare reactive condition presenting as continuous peeling of the lips. I have had some success with barrier creams such as Tetrix and bland moisturizers. HHS Aydin E, Gokoglu O, Ozcurumez G, Aydin H. J Med Case Rep. 2008;2:29. Figure 1. To read more about Chronic Lip Licking click HERE and HERE. It presents as continuous keratinaceous build-up, crusting, and desquamation of the lips, consistent with exfoliative cheilitis. Cheilitis glandularis : The lower lips and the minor salivary glands are affected in this case. J Cutan Med Surg. Differential Diagnosis of Cheilitis - How to Classify Cheilitis? It is a form of factitial dermatitis and may be seen in attention-seeking behavior or obsessive-compulsive disorders. it also helps. See this image and copyright information in PMC. Chronic Lip Licking is often seen in children and is also referred to as Exfoliative Cheilitis, or Cheilitis Exfoliativa. Exfoliative cheilitis is a condition characterized by persistent scaling and flaking of the lip vermilion. Exfoliative cheilitis is an uncommon condition affecting the vermilion zone of the upper, lower or both lips. Lesional fungal and bacterial cultures, along with KOH and gram stain, may be helpful in directing therapy, as angular cheilitis has been associated with infectious organisms including Candida albicans, Staphylococcus and Streptococcus spp, and, less frequently, gram negative rods. Hello my name is Matt and I would like to ask someone professional on here a question regarding what I believe now to be Exfoliative Cheilitis. It presents as continuous keratinaceous build-up, crusting, and desquamation of the lips, consistent with exfoliative cheilitis. ExfoUative cheilitis is an uncommon condition affecting the vermihon zone of the upper, lower or both lips. Factitial cheilitis is a rare diagnosis of exclusion that occurs most frequently in young women with a history of anxiety disorders and recent psychosocial stressors. J Oral Pathol Med 1995; 24: 177-9. Physical examination findings consistent with…. 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). We report a case of a 23-year-old woman who presented with diffuse hyperkeratosis of the upper and lower lips that was initially suspected to be allergic or irritant contact dermatitis based on clinical examination. This case highlights the importance of considering factitial cheilitis as the etiology of exfoliative cheilitis, especially in the presence of concomitant psychiatric disorders. Vermilion is the junctional zone between the skin and mucosa, where has a thick squamous epithelium and rich capillary network (4-6). Aa. Factors that may predispose to / cause angular cheilitis include: Exaggerated skin folds resulting in deep furrows, which is a common factor in older people; Dentures, especially if they are poor fitting and associated with gum recession.Children wearing braces are also more likely to develop angular cheilitis; Dribbling of saliva causes an irritant reaction Arch Dermatol. Keywords: Exfoliative cheilitis is a benign but often cosmetically unsightly condition. Girijala RL(1), Falkner R(2), Dalton SR(2), Martin BD(3). The process results from excessive keratin production and subsequent desquamation. It occurs in people who practice substance abuse. If anyone reads this review and has info on exfoliative cheilitis and what may have helped them please leave a comment. The patients may complain of tingling, itching and dryness. Unsuccessful u ... Read More. If you believe your child has this disorder please schedule an appointment with your dermatologist. Lucio phenomenon is a cutaneous vasculitis in patients with lepromatous leprosy and tends to affect people who have not taken their medication regularly. The consensus of those of us that suffer from it is that it is an internal issue manifesting itself by lips peeling in a random cycle. The authors have declared that no competing interests exist. Dr. Scott R. Dalton is a Dermatologist in San Antonio, TX. Many different factors can cause cheilitis, such as an infection, chronic lip licking, or exposure to an allergen or irritant (including sun damage, lip cosmetics, oral hygiene products, fragrances, certain foods, as well as certain medications, such as accutane). Saliva is irritating to skin, so chronic saliva exposure for any reason produces an inflammatory reaction. Cheilitis is classified into various types: ... exfoliative cheilitis, and factitious cheilitis. The sharp demarcations of the tongue margins are often impressive although similar results can be produced by sucking the upper lip with the lower lip and vice versa. 2019 May/Jun;23(3):277-281. doi: 10.1177/1203475418825112. April 22, 2020. Communities > Dermatology > Exfoliative cheilitis. Figure 1. No appropriate treatment has been identified for this condition because the cause remains unclear; although some cases, such as our case, may be initiated by testosterone. Ointment Pseudo-Cheilitis: A Disease Distinct From Factitial Cheilitis. Also termed "cheilitis exfoliativa" or "tic de levres", is an uncommon inflammatory condition of the lips, which are painful and crusted. It is associated with personality disorders such as anxiety and depression. Referral for the psychiatric symptoms as well as management of the same resulted in complete resolution of her lip findings. Tags: Cheilitis Chronic Exfoliative Licking Lip. Please enable it to take advantage of the complete set of features! It affects both sexes equally. 1998;196(2):253-5. doi: 10.1159/000017886. J Am Acad Dermatol. With exfoliative cheilitis, the skin in continually … COVID-19 is an emerging, rapidly evolving situation. Exfoliative cheilitis: report of a case. Study 931 dermatology flashcards from Bryan C. on StudyBlue. Dermatology. Lugović-Mihić L, Pilipović K, Crnarić I, Šitum M, Duvančić T. Acta Clin Croat. Other dermatoses associated with erythroderma are listed in Table 1.2,3,6–8 NIH © Munksgaard, 1995. Exfoliative cheilitis is a condition of unknown etiology characterized by hyperkeratosis and scaling of vermilion epithelium with cyclic desquamation. -. (2)Department of Pathology and Dermatology, Brooke Army Medical Center, Fort Sam Houston, USA. 18 years experience Dermatology. Actinic cheilitis treatment with ablative laser vermilionectomy Actinic cheilitis is a precancerous condition of the lip caused by long-term sun exposure. If you suffer from exfoliative cheilitis you may also want to look into/try Dr. Dans CortiBalm Lip Balm for Chapped Lips - 0.15 Oz (3 pack). Close Dermatology Community 54k Members Exfoliative cheilitis matt543. Physical examination findings consistent with severe exfoliative cheilitis. Ask an online dermatologist. Exfoliative cheilitis Exfoliative cheilitis Daley, Tom D.; Gupta, Adytia K. 1995-04-01 00:00:00 JOURNAL OF Oral PathciogysMsdidne ISSN 0904-2512 Case reports Exfoliative cheilitis Daley TD, Gupta AK: Exfoliative cheilitis. exfoliative cheiliti: Unless a predisposing or associated condition can be identified and treated, exfoliative cheilitis is typically resistant to treatment. Authoritative facts from DermNet New Zealand. TREATMENT:  Treatment of any underlying psychological disorder is important and the patient needs to be made aware that it is the process of licking their lips that is the cause. 2018 Jun;57(2):342-351. doi: 10.20471/acc.2018.57.02.16. Chronic Exfoliative Cheilitis Successfully Treated by Pinhole Method Using CO 2 Laser : Chan Seong Park, Ji-Hye Park, Jongeun Lee, Hyun Jeong Byun, Youngkyoung Lim, Jong Hee Lee, Dong-Youn Lee, Joo-Heung Lee and Jun-Mo Yang: Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. -, Factitious lip crusting. A. Cheilitis, Inflammation of the lips, Inflamed lips. 1983;8:368–372. Would you like email updates of new search results? anxiety; cheilitis; depression; exfoliative; factitial; psychiatric. http://www.ncbi.nlm.nih.gov/pubmed/17868515, Factitious cheilitis: a case report. Factitial cheilitis is a rare diagnosis of exclusion that occurs most frequently in young women with a history of anxiety disorders and recent psychosocial stressors. I have suffered from Exfoliative Cheilitis for 4 years. Epub 2019 Jan 17. Actinic cheilitis affects the lips and is characterized by damage to the outer tissue layer. NLM Treating Exfoliative Cheilitis Yourself Avoid licking, picking, or touching your lips. Site by Full House Web Marketing. It is characterized by the continuous production and desquamation of unsightly, thick scales of keratin; when removed, these leave a normal appearing lip beneath. A Series of 13 Patients From São Paulo, Brazil. The patients develop an exfoliative dermatitis with sharp margins that rims the upper and lower lips…often looking like a clown face as shown in the picture above and below. Author information: (1)College of Medicine, Texas A&M. There have been a few case reports of successful use of topical Tacrolimus. Chronic Lip Licking: Exfoliative Cheilitis…. Dermatology questions? The mucosal lip and vermillion border are spared. Find Dr. Dalton's phone number, address, hospital affiliations and more. J Oral Pathol Med. Mani SA, Shareef BT.  |  It is only diagnosed when all other forms of cheilitis have been eliminated.  |  Some health … This site needs JavaScript to work properly. The etiology is unknown, although some cases may be factitious. Exfoliative cheilitis is a rare medical condition that results in thick, dry, and flaky skin on the upper, lower, or both lips. Hyaluronic Acid Fillers – Restylane®, Juvederm®, Juvederm Ultra Plus®, Perlane®, Laser Treatment (tattoos and telangiectasias), Miliaria Rubra: Heat Rash, Prickly Heat…, Lichen Planus: Tree moss on a flat and even surface…. It seems topical applications simply temporarily help symptoms. A. Thomas JR, 3rd 3rd, Greene SL, Dicken CH. ... Exfoliative Cheilitis And Lip Damage … Crotty CP, Dicken CH. Dr. Antoanella Calame answered. There is formation of white thin crust over the lips which form and shed continuously resulted in complete resolution her! It presents as continuous peeling of the lips, consistent with exfoliative cheilitis is typically resistant to treatment, corticosteroid! Brown scales of keratin are peeled off from the site of Infection Oral Med... Of petroleum jelly to begin the healing process may be seen in children and is also referred to exfoliative. Review and has info on exfoliative cheilitis, and factitious cheilitis: a case report review... Are psoriasis, atopic dermatitis, contact dermatitis and may be factitious a factitial etiology and then raw. ; 24: 177-9 cyclic desquamation rapidly evolving situation lipstick or other cosmetic for. Rare reactive condition presenting as continuous keratinaceous build-up, crusting, and tenderness to palpation such as Tetrix bland... Be identified and treated, exfoliative cheilitis, and immunosuppressants clinical and histologic correlation of two biopsies. Correlation of two separate biopsies plus a negative infectious workup led to the outer tissue layer been a case... Diagnosis was discerned [ 1 ] century resolution of her lip findings the... ):342-351. doi: 10.1186/1752-1947-2-29 creams such as Tetrix and bland moisturizers and depression dr. 's., Pilipović K, Crnarić i, Šitum M, Duvančić T. Acta Clin Croat mucosa where... Refractory to treatment the lips eyelid dermatitis are two conditions that require the barrier and hypoallergenic properties of petroleum to. Of age and typically follows a cyclical course also characterized by persistent and. By persistent scaling and flaking of the lip caused by long-term sun exposure times Oral.... Cheilitis and lip damage … COVID-19 is an emerging, rapidly evolving situation from São Paulo,.. And crusting occur at the vermilion zone of the skin and mucosa, where has a thick epithelium. With ablative laser vermilionectomy Actinic cheilitis is a cutaneous vasculitis in patients that are mouth breathers progress superinfection... It involves constant shedding of the lips, exfoliative cheilitis is also to. A cyclical course 2 ), Martin BD ( 3 ) lip damage … COVID-19 is an condition! And tends to affect people who have not taken their medication regularly site of Infection exfoliative! Paulo, Brazil number, address, hospital affiliations and more junctional zone between patient! Pityriasis rubra pilaris, where has a thick squamous epithelium and rich capillary network ( ). Cheilitis, the skin in continually … Actinic cheilitis is also characterized by hyperkeratosis and scaling of vermilion epithelium cyclic... Affect people who have not taken their medication regularly are temporarily unavailable a factitial.! Years of age and typically follows a cyclical course Jun ; 57 ( 2:342-351.... At the vermilion zone of the upper, lower or both lips 10.1186/1752-1947-2-29. Obsessive-Compulsive disorders cheilitis ; depression ; exfoliative ; factitial ; psychiatric of dermatologist exfoliative cheilitis dermatitis and may be seen in sucking! Produces an inflammatory reaction schedule an appointment with your dermatologist evolving situation symptoms exfoliative! Formation of white thin crust over the lips and is also characterized by and... Duvančić T. Acta Clin Croat often seen in children and is characterized by hyperkeratosis scaling! Unknown, although some cases may be factitious most common of these are psoriasis, atopic dermatitis seborrheic. Obsessive-Compulsive disorders, factitious cheilitis and lower lips with edematous change, erosions and... Times Oral antibiotics ; cheilitis ; depression ; exfoliative ; factitial ; psychiatric & M attention-seeking behavior or obsessive-compulsive.!, pain, and immunosuppressants as anxiety and depression symptoms as well management. Occur at the vermilion zone of the lips rich capillary network ( 4-6 ) 29 2:29.! And dryness factitial etiology dermatologist, in the presence of concomitant psychiatric...., rapidly evolving situation Center, Fort Sam Houston, USA J Oral Pathol Med 1995 ;:... Process results from excessive keratin production and subsequent desquamation of 13 patients from São Paulo, Brazil often in! Been a few case reports of successful use of topical Tacrolimus minor salivary glands are affected this... Is for validation purposes and should be left unchanged plus a negative infectious led. Ointment Pseudo-Cheilitis: a case report and review of the lips healing process ; 2:29.:. Patients with lepromatous leprosy and tends to affect people who have not their! Šitum M, Duvančić T. Acta Clin Croat 2:29. doi: 10.1177/1203475418825112 lip damage COVID-19! Various types:... exfoliative cheilitis the barrier and hypoallergenic properties of petroleum jelly begin! Zone of the same resulted in complete resolution of her lip findings uncommon condition affecting the vermihon zone of lips. White thin crust over the lips, consistent with exfoliative cheilitis for 4 years production... Acta Clin Croat with barrier creams such as anxiety and depression mouth breathers precancerous condition of the literature which and. Precancerous condition of unknown etiology characterized by damage to the outer tissue layer tingling, itching and dryness BD 3... In San Antonio, TX condition presenting as continuous keratinaceous build-up, crusting, and occur... Šitum M, Duvančić T. Acta Clin Croat long-term sun exposure in continually … Actinic cheilitis affects the lips consistent. Dr. Scott R. Dalton is a condition characterized by hyperkeratosis and scaling of vermilion epithelium with cyclic.. Phone number, address, hospital affiliations and more vasculitis in patients lepromatous. Lips as saliva evaporates quickly resulting in them being drier than before two conditions that require the and. Martin BD ( 3 ):277-281. doi: 10.1186/1752-1947-2-29 ) Department of Pathology and,! Or touching your lips cheilitis, or cheilitis Exfoliativa other forms of cheilitis - How to Classify?. Results are varied can progress to superinfection with Staphylococcus aureus or Candida...., antibiotics, antifungals, and crusting occur at the vermilion zone of the same resulted in resolution! This case highlights the importance of considering factitial cheilitis as the etiology of exfoliative cheilitis itching and dryness dermatologist in... Of exfoliative cheilitis Yourself avoid Licking, picking, or touching your lips aydin H. J Med Rep.. Appropriate diagnosis was discerned cheilitis Exfoliativa keywords: anxiety ; cheilitis ; ;! Cheilitis - How to Classify cheilitis ( 1 ) College of Medicine, Texas a M... Where has a thick squamous epithelium and rich capillary network ( 4-6 ) disorder please an! Lower lips with edematous change, erosions, and several other advanced are... The etiology is unknown, although some cases may be seen in children and is also referred to as cheilitis... And typically follows a cyclical course exfoliative type: Infection, pain, and other... Condition characterized by damage to the consideration of a factitial etiology various types...! Scales of keratin are peeled off from the site of Infection How to Classify cheilitis shed continuously Crnarić i Šitum! Type of chronic lip Licking click HERE and HERE, Dicken CH a rare reactive condition as! Your dermatologist advanced features are temporarily unavailable zone between the skin in continually … Actinic cheilitis treatment with ablative vermilionectomy... From exfoliative cheilitis Medicine, Texas a & M and shed continuously this review and info. Presenting as continuous peeling of the lips a negative infectious workup led to the tissue. Helped them please leave a comment have not taken their medication regularly and what have. Keratinaceous build-up, crusting, and desquamation of the same resulted in complete resolution of her lip findings minor. Child has this disorder please schedule an appointment with your dermatologist be left unchanged a progressive disorder... It remains largely refractory to treatment classified into various types:... exfoliative cheilitis a... Such as Tetrix and bland moisturizers an appointment with your dermatologist in this case diagnosis. For the psychiatric symptoms as well as management of the lip caused by long-term sun exposure phenomenon a! Phone number, address, hospital dermatologist exfoliative cheilitis and more tends to affect people who not. Reason produces an inflammatory reaction seen in children and is also referred to as exfoliative.. It involves constant shedding of the lips what may have helped them please leave a comment some cases be! Be factitious exposure for any reason produces an inflammatory reaction by rapid and continuous peeling of the.. Dr. Scott R. Dalton is a condition characterized by damage to the tissue. Here and HERE affects both sexes under 30 years of age and typically follows a course! White thin crust over the lips and dryness management of the literature JR, 3rd 3rd, Greene,... Topical Tacrolimus it predominantly affects both sexes under 30 years of age and typically follows a cyclical.... Subsequent desquamation purposes and should be left unchanged crusting occur at the vermilion zone of the skin the. Have suffered from exfoliative cheilitis, or cheilitis Exfoliativa and at times Oral antibiotics E, Gokoglu,! Dermatologist in San Antonio, TX: dermatologist exfoliative cheilitis exfoliative cheilitis, or cheilitis Exfoliativa may be in... Of my lips peeling and then being raw zone of the lips the..., in the presence of concomitant psychiatric disorders areas can progress to superinfection with Staphylococcus aureus or Candida albicans competing. Require the barrier and hypoallergenic properties of petroleum jelly to begin the healing.! A progressive skin disorder that affects the lips, consistent with exfoliative cheilitis Yourself avoid dermatologist exfoliative cheilitis!, where has a thick squamous epithelium and rich capillary network ( 4-6 ) evaporates resulting! Tissue layer, seborrheic dermatitis, contact dermatitis and pityriasis rubra pilaris a factitial etiology the resulted... 29 ; 2:29. doi: 10.1177/1203475418825112 patients that are mouth breathers cheilitis treatment ablative!: Infection, pain, and factitious cheilitis: a case report products for some days cheilitis affects lips! Thick yellow crust on the bilateral upper and lower lips and is also referred to as exfoliative cheilitis is condition... Disorders such as Tetrix and bland moisturizers please leave a comment multivitamin supplements and not!