exfoliative cheilitis
Introduction
Introduction to exfoliative cheilitis Exfoliative cheilitis (cheilitisexfoliativa) is a chronic inflammation of the lips caused by chemicals, sunlight or unexplained causes. Exfoliative cheilitis is also known as chronic cheilitis and chronic actinic cheilitis. The rash often begins in the middle of the lower lip and then gradually spreads to the entire lower lip or upper and lower lips, sometimes crusting, cracking, dryness and pain. Most of the area has a tingling or burning sensation, the lips are diffusely swollen and the color is normal. It is softer. After a slow period, the condition lasts for several months to several years. basic knowledge The proportion of illness: the incidence rate is about 0.003% - 0.009% Susceptible people: more common in young women Mode of infection: no specific population Complications: oral cancer
Cause
The cause of exfoliative cheilitis
Causes:
The cause is still unclear. Often secondary to seborrheic dermatitis, atopic dermatitis, psoriasis, oral vitamin A treatment, or patients with habitual lip biting, labrum. Sunlight, local chemical factors (such as lipstick, toothpaste, spicy food, etc.) can also cause the disease.
Sunlight (25%):
Sunlight is too long, caused by UV damage to the lip membrane. Generally, the following lips are more common. On the basis of congestion and edema of the red part of the lips, erosion and exudation are the main features. The general damage range is limited to the lip red part, which does not exceed the red edge of the lip and does not spread to the skin part. There is a yellow exudate in the erosion area. As the inflammation is relieved, the exudation gradually decreases from the oozing to the scarring and healing. The infected face can be purulent. The patient consciously had local burning, itching and unbearable, and the corresponding lymph nodes were swollen and tender. Recurrent areas can leave pigmentation.
Various external stimuli (35%):
Eczema erosive cheilitis may be related to mental and disease, most of which may be related to various long-term chronic persistent stimuli, which may be caused by high temperature operation or outdoor work, so it is called photochemical cheilitis. Ingestion of porphyrin-containing foods, taking western medicines such as chlorpromazine, isoniazid, etc., or using traditional Chinese medicine angelica, psoralen, etc., can cause porphyrin metabolism disorder, in this case, after sun exposure, confrontation The morpholine is highly allergic to ultraviolet light and induces the disease. Others such as bad habits such as biting the lips are also predisposing factors.
Pathogenesis:
Local manifestations of local lesions or systemic diseases: alveolar pyorrhea, seborrheic dermatitis, sebaceous gland ectopic disease, atopic dermatitis, pediatric pruritus, etc., emotional factors: after the mental fluctuations can occur or aggravate the condition, nutrients, such as: Vitamin B deficiency, especially riboflavin, lack of niacin, or caused by gastrointestinal dysfunction.
Prevention
Exfoliative cheilitis prevention First of all, we must correct bad habits, do not rub your lips, bite your lips or expose the dandruff of your lips; secondly, reduce the stimulation of tobacco and alcohol, eat less spicy and greasy products, and avoid sun exposure. Usually lips are often moisturized with lip balm or lip balm. They are often served with spleen and dampness, such as glutinous rice, medlar, medlar, and red bean.
Complication
Exfoliative cheilitis complications Complications, oral cancer
People often have chronic cheilitis caused by chronic irritation such as licking lips, biting lips, lip balm or hot smoking, and may also turn into oral cancer. Experts pointed out that in the autumn dry, the public must not look down on the dryness, cleft palate and desquamation of the lips, because these itchiness, congestion, swelling and smashing "small hair disease", is not allowed to be the initial signs of cancer.
Most oral cancers are found in the middle and late stages. Long-term chronic stimuli, such as: smoking, drinking, eating too much food, chewing betel nut, improper dentures, etc. caused by erosion, ulcers and hyperplasia, these lesions, such as long-term unhealed, easy to develop into oral cancer. Currently recognized oral precancerous lesions mainly include red spots, white spots, and oral submucous fibrosis. Oral lichen planus, discoid lupus erythematosus, chronic cheilitis, etc. also have a certain tendency to malignant.
The canceration rate of oral leukoplakia is about 3%-5%. In addition to the rough discomfort, the patient did not have obvious symptoms at first, and most of them were occasionally found during oral examination; white spots can occur in the cheeks, lips, tongue, palate and gums. For older patients, especially those over the age of 60 and smokers, the likelihood of malignancy is greater. However, oral erythema is not as common as leukoplakia, but the cancer rate is high, about 90%.
Symptom
Exfoliative labitis symptoms common symptoms dry lips and blood stasis
The damage only occurs in the red part of the lips, especially in the lower lip. It is more common in young women. The rash often begins in the middle of the lower lip and gradually spreads to the entire lower lip and upper lip. It is characterized by dry and swollen lips, erosion, exudation, and surface. There are scars and scales. After the scales fall off, the red smooth surface is revealed. The cracks occur repeatedly and are difficult to heal for a long time. It lasts for several months and is consciously burning or painful.
Examine
Exfoliative cheilitis
1. Dry desquamation type. Pathological examination: basal cell vacuolar degeneration, daylight degeneration.
2. Eczema erosive cheilitis.
(a) actinic cheilitis
Pathological examination: acute damage to fine intracellular and intercellular edema, blister formation.
(B) benign lymphoproliferative cheilitis
Pathological examination: submucosal lymphoid follicular hyperplasia.
3. Adenoid cheilitis. Pathological examination: non-specific glandular hyperplasia, enlargement, inflammatory cell infiltration.
4. Granulomatous cheilitis. Pathological examination: granulomatous nodules, with Langerhans cells.
Diagnosis
Diagnosis and identification of exfoliative cheilitis
Red lips, especially the scaly recurrence of the lower lip, crusting damage is helpful for diagnosis.
Chinese medicine believes that "the spleen is open to the mouth, its Hua is in the lips", "the spleen and the stomach are in the table", so the lip disease is closely related to the function of the spleen and stomach, that is, "the spleen and stomach are hot, the air is in the lips, the lips", the spleen and stomach are hot and fumigation. Can cause redness, erosion, exudation, and long-term blood deficiency, yin deficiency and dandruff repeatedly peeling off.
Differential diagnosis
1. Contact cheilitis: There is a clear history of exposure, the severity of the symptoms is related to the chance of contact, and the patch test is generally positive.
2. Glandular cheilitis: There are many glandular nodules and mucus opening holes in the lips. If you squeeze the lips, you can secrete mucus. Sometimes you can touch the nodules formed by cysts. The disease has a family-like tendency.
3. Actinic cheilitis: related to daylight, the following lips are dominant, and outdoor workers are more common in summer.
4. Granulomatous cheilitis: One side of the lips has an unknown swelling, hypertrophy, histopathology can be seen in the granuloma of the dermis.
5. Discoid lupus erythematosus: multiple invasion and lower lip, clear skin lesions, red purple patches, atrophic changes and telangiectasia.
6. Lichen planus: more invasive and lower lip, pale white patch or invasive patch, which may have water sores, few chapped, bleeding and other symptoms, in the buccal mucosa, gums, hard palate and other mucosa may have the same Skin lesions have characteristic changes in pathology.
