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Chronic lip fissure

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Chronic lip fracture often develops on the lower lip, but localization is possible on the upper lip (24%). The course of this disease is prolonged with alternation of remissions and relapses, which is facilitated by neurodistrophic and metabolic disturbances revealed in the tissues surrounding the chronic fissure. Chronic lip rupture can occur in both sexes, in all age groups.

ICD-10 code

By 13.08 Other specified diseases of the lips.

Causes

In the development of this pathology, great importance is given to the anatomical features of the structure - full lips with a pronounced central fold or constriction. Chronic lip fracture develops against unfavorable meteorological influences, causing dryness, peeling, loss of elasticity of the red rim. The development of dryness, sensitivity of the lips to injuries contribute to hypovitaminosis A and group B (especially B2 and B6). The attachment of the microbial factor maintains the chronic course of the lip crack.

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Symptoms

Chronic lip fracture manifests itself as a single, deep linear defect that passes more often in the center of the lip, which is accompanied by soreness. The crack can be covered with bloody crusts. The length of the linear defect varies from 0.2 to 1.5 cm. It is possible to attach a pyogenic infection, which is accompanied by the appearance of hyperemia, edema of surrounding tissues, the surface of the crack is covered with yellow crusts.

With the prolonged existence of a crack, a painful infiltration appears at the base, the edges become denser, the epithelium in the circle becomes turbid and becomes whitish in color. In the future, malignancy can occur, which is manifested by the consolidation of the edges and the base, the keratinization of the margins, small papillomatous growths in the depth of the crack are possible.

Treatment

Preserve conservative and surgical treatment

Local conservative therapy includes:

keratoplasty (rosehip oil, sea-buckthorn), fatty creams such as irikar, radevit;
antimicrobial agents with expressed infection (10% synthomycin emulsion, Levosin, Levomekol, etc.);
glucocorticoid ointments with antibacterial action (betamethasone + fusidic acid (fucicort), betamethasone + gentamicin (whiteant), etc.);
Novocaine (lidocaine) blockades of 0.25%. 0.5%, 1% solutions, injected with a fire chamber needle under the crack base from the side of the mucosa. It is enough 1-2 blockades (with an interval of 5-7 days) for achievement of proof medical effect;
laser therapy - Helium-neon laser stimulates healing.

It is recommended to use inside the vitamin preparations (zenith, a complex of vitamins of group B).

Operative treatment - surgical excision is indicated in cases of cicatricial atrophy, compaction of margins or hyperkeratosis.

What is the prognosis of a chronic lip crack?

The prognosis is favorable, but the long-term existence of this pathology is considered as a background disease capable of malignancy (6%).

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