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Chronic cleft lip
Last reviewed: 05.07.2025
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Chronic lip crack most often develops on the lower lip, but localization on the upper lip is possible (24%). The course of this disease is long with alternating remissions and relapses, which is facilitated by neurodystrophic and metabolic disorders detected in the tissues surrounding the chronic crack. Chronic lip crack can occur in both sexes, in all age groups.
ICD-10 code
By 13.08 Other specified diseases of the lips.
Reasons
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 crack develops against the background of unfavorable meteorological effects, causing dryness, peeling, loss of elasticity of the red border. The development of dryness, sensitivity of the lips to injuries is facilitated by hypovitaminosis A and group B (especially B2 and B6). The addition of a microbial factor maintains the chronic course of lip crack.
Symptoms
A chronic lip crack is manifested by a single, deep linear defect, most often passing along the center of the lip, which is accompanied by pain. The crack may be covered with bloody crusts. The length of the linear defect varies from 0.2 to 1.5 cm. It is possible to add a pyogenic infection, which is accompanied by the appearance of hyperemia, edema of the surrounding tissues, the surface of the crack is covered with yellow crusts.
With a long-term existence of a crack, a painful infiltrate appears at the base, the edges become denser, the epithelium in the circumference becomes cloudy and whitish. Malignancy may occur later, which is manifested by compaction of the edges and base, keratinization of the edges, small papillomatous growths are possible in the depth of the crack.
Treatment
Conservative and surgical treatment are distinguished.
Local conservative therapy includes:
- keratoplasty (rosehip oil, sea buckthorn oil), fatty creams such as Iricar, Radevit;
- antimicrobial agents for severe infections (10% syntomycin emulsion, Levosin, Levomekol, etc.);
- glucocorticoid ointments with antibacterial action (betamethasone + fusidic acid (fucicort), betamethasone + gentamicin (belogent), etc.);
- novocaine (lidocaine) blockades 0.25%. 0.5%, 1% solutions, introduced with a thin needle under the base of the crack from the side of the mucous membrane. 1-2 blockades (with an interval of 5-7 days) are sufficient to achieve a lasting therapeutic effect;
- Laser therapy - helium-neon laser stimulates healing.
It is recommended to take vitamin supplements orally (Zenit, B vitamin complex).
Surgical treatment - surgical excision is indicated in cases of cicatricial atrophy, compaction of the edges or hyperkeratosis.
What is the prognosis for chronic cleft lip?
The prognosis is favorable, but the long-term existence of this pathology is considered an underlying disease capable of malignancy (6%).