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Allergic contact cheilitis
Last reviewed: 04.07.2025
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Allergic contact cheilitis is a lip disease that develops as a result of direct contact with substances that can cause a delayed-type allergic reaction.
ICD-10 code
- L23 Allergic contact dermatitis.
- L23.2 Allergic contact dermatitis due to cosmetics.
- L23.2X Manifestations in the oral cavity.
The vast majority of patients with allergic contact cheilitis are women aged 20 to 60 years.
Reasons
Allergic contact cheilitis is a response to contact sensitization, which can be caused by a wide variety of substances, but most often by cosmetics (lipstick, creams).
Cosmetics are mixtures of many components, but sensitization is most often caused by preservatives and stabilizers. Contact allergic reaction of the lips can be caused by plastic dentures. The main source of sensitization in plastic is considered to be products of incomplete polymerization.
[ Symptoms
Characteristic features include stagnant hyperemia, slight swelling, peeling, itching and burning of the lips. Acute course of the disease with the appearance of small blisters, oozing is possible. The process affects the entire red border of the lips, but, certainly, in some area it goes to the surrounding skin, which creates a clinical picture of blurred borders of the red border. The corners of the mouth are not involved in the pathological process. With a long-term chronic course, peeling, lichenification at the border with the skin, and the appearance of cracks are possible.
Diagnostics
Diagnosis is based on the characteristic clinical picture (transition of the lesion to the skin) and on anamnesis data (use of new cosmetics, creams a couple of weeks before the appearance of cheilitis).
The final diagnosis can be confirmed by skin testing using the patch method with the suspected allergen. However, skin tests do not always give positive results. In clinical practice, the elimination effect plays a role in confirming the diagnosis, i.e. recovery or a sharp improvement in the condition after stopping contact with the suspected substance.
Differential diagnostics
Differential diagnostics are carried out with other, more often dry forms of cheilitis - dry exfoliative cheilitis, dry actinic cheilitis, exfoliative cheilitis (dry form) appears strictly on the red border of the lip, never affecting the border skin.
The dry form of actinic cheilitis has a clear dependence (exacerbation) on the effects of insolation.
Treatment
Treatment includes the appointment of:
- antihistamines (loratadine, desloratadine, cetirazine, etc.);
- calcium preparations;
- glucocorticoid ointments [flumethasone + salicylic acid (lorinden),
- locoid, fluocinolone acetoid (Flucinar), mometasone, methylprednisolone aceponate (Advantan), etc.|.
What is the prognosis for allergic contact cheilitis?
The prognosis is favorable. To prevent relapse of the disease, repeated contact with the allergen is unacceptable.