glandular cheilitis
Introduction
Introduction to glandular cheilitis Glandularis cheilitis (glandularischeilitis), also known as myxadenitislabiaris, is a mucinous glandular hyperplasia of the lips, accompanied by ductal dilatation and varying degrees of inflammatory response, and is susceptible to secondary infection. The disease is similar to the traditional Chinese medicine "lip lips", such as "Surgical Treatment of the Whole Book" records: "White skin vesicles on the lips, gradually swollen like silkworm cocoons, or under the lips swollen like black dates, dry and itchy, all seven emotions Fire and blood damage." basic knowledge The proportion of illness: the incidence rate is about 0.003% - 0.009% Susceptible people: multiple adult males Mode of infection: non-infectious Complications: swelling
Cause
Cause of glandular cheilitis
(1) Causes of the disease
Congenital: There is a hereditary family history, which is autosomal dominant, mostly in children or young people, and some patients may develop cancer.
Acquired: It can be caused by stimuli, such as trumpeting, or can be caused by toothpaste, mouthwash, smoking, poor oral hygiene, etc. Sunlight and mental factors can also cause the disease.
(two) pathogenesis
The above causes may cause blockage and/or infection of the small salivary glands, causing swelling of the lips and formation of nodules.
Prevention
Glandular cheilitis prevention
The etiology of this disease is not clear, and may have certain correlation with environmental factors, genetic factors, dietary factors, and mood and nutrition during pregnancy. Therefore, it is impossible to directly prevent the disease against the cause. Early detection, early diagnosis, and early treatment are important for indirect prevention of this disease, and can also reduce the incidence of infection complications. For patients with existing infections, antibiotics should be used as soon as possible.
Complication
Glandular cheilitis complications Complications swelling
In addition to local pain and purulent secretion, the disease can also be complicated by local suppurative infection. And because the skin integrity is destroyed, it can induce skin bacterial infection or fungal infection, usually secondary to low body constitution, or long-term use of immunosuppressants and fungal infections such as onychomycosis, such as concurrent bacterial infections may have fever, skin Swelling, rupture and purulent secretion flow out and other performances. Severe cases can lead to sepsis, which should be brought to the attention of clinicians.
Symptom
Glandular labial symptoms common symptoms sputum purulent discharge yellow nodules upper lip hypertrophy upper lip edema
Classification and clinical manifestations:
Simple glandular cheilitis: the most common, its salivary gland hyperplasia, ductal dilatation without inflammation, characterized by several to dozens of small yellow nodules 2 to 4 mm in the lip, central concave, dilatation of the orifice It can extrude mucus-like substances, the mucous membrane of the lips is moist, crusted, hypertrophy, and the lip is enlarged, which can reach 2 to 3 times of normal people. If it is accompanied by secondary infection, it can develop into purulent lesions.
Superficial purulent glandular cheilitis: also known as Baelz disease, this type only invades the duct and the salivary gland itself has no effect, the lips are swollen, painful, hard, with superficial ulcer, surface scarring, purulent underarm Sexual secretions, after peeling, reveal a red moist base, which can discharge micro-mixed or purulent liquid when squeezed. After entering the chronic phase, the surface of the mucosa may change with leukoplakia.
Deep suppurative glandular cheilitis: can involve salivary glands and ducts, lip infections with abscesses and fistula formation, recurrent episodes of abscesses and scars. After slow, squeeze lips can discharge purulent fluid, lip enlargement Consciously pain and discomfort, systemic symptoms are generally not obvious, there are reports of this type of cheilitis over the age of 40, when long-term unhealed, malignant transformation can occur.
The lower lip is swollen, and the lips are red with multiple yellow nodules, accompanied by inflammatory changes in the mucous glands.
Examine
Examination of glandular cheilitis
Histopathology: normal human lips and salivary gland ducts open in the mucosa, the lack of or a small number of lip red parts in contact with the outside, and in this disease, lip salivary gland hyperplasia, glandular dilatation, secretion, that is, atopic Hyperplasia, the main pathological changes are: early glandular tissue hyperplasia, ductal dilatation, and inflammation is a secondary process, the salivary gland is enlarged at the edge of the lip red and its adjacent mucosa, and its duct is dilated, containing eosinophilic sputum. Mucin substances, irregular epidermal hyperplasia, accompanied by sponge formation, acanthosis hypertrophy, lymphocyte and plasma cell infiltration, or granulomatous changes, and some areas have a large number of neutrophil infiltration.
Diagnosis
Diagnosis and differentiation of glandular cheilitis
According to the clinical manifestations of this disease, it should be differentiated from actinic cheilitis, exfoliative cheilitis and squamous cell carcinoma.
1. Actinic cheilitis: acute onset, history of exposure. The red part of the lips is extensively edematous, congested, and eroded, and the surface is covered with bloody or erosive surfaces. It has intense itching and a burning sensation. Because the lesion can affect the entire lower lip, it affects eating and speaking. Deeper lesions will leave scars after healing. Systemic symptoms are mild or absent, and can heal itself or become chronic within 2 to 4 weeks.
2. Exfoliative cheilitis: The main features of redness, erosion, cleft palate and desquamation of the lip mucosa are mild and heavy, and they are not cured for a long time. Modern medicine believes that its incidence is related to cold, dry, sun exposure, alcohol and tobacco stimulation, as well as lips, biting lips, musical instruments and other factors. Chinese medicine calls it "lip wind", and believes that this disease may be caused by wind, fire, poison, evil, and spleen, or because of eating spicy and thick taste, spleen and stomach dampness, smoldering the lips, or due to blood and dry skin.
