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Eczema on the lips (eczematous cheilitis)
Last reviewed: 23.04.2024
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Eczema on the lips (eczematous cheilitis) is a chronic relapsing skin disease of the neuro-allergic nature, characterized by serous inflammation of the surface layers of the skin, itching and resulting from the action of external and internal factors.
ICD-10 code
L30 Other dermatoses.
Eczema on the lips is common among women and men aged 20-40 years.
What causes eczema on the lips?
It is believed that eczema on the lips develops due to the complex effects of neuro-allergic, endocrine, metabolic and exogenous factors. Exogenous irritants can be chemical, biological agents, bacterial allergens, physical factors, medicines, food products, cosmetics.
For patients with eczematous cheilitis, the development of polyvalent sensitization is characteristic, in particular, to dental materials - denture metals, amalgams, plastics, toothpastes, creams, etc. An eczematous reaction is a delayed-type allergic reaction.
The development of eczema is possible against the background of long-existing cracks in the lips. This kind of microbial eczema (near-root) reflects the state of skin sensitization to microbial allergens, which is confirmed by skin-allergic reactions with specific antigens. More often, sensitization to streptococci and staphylococci is detected.
Symptoms
Acute, subacute and chronic eczematous cheilitis are distinguished along the course.
The whole red border of the lips is affected, the pathological process extends widely to the skin of the face,
Acute eczema on the lips is characterized by itching, sharp swelling, hyperemia, the appearance of numerous small vesicles (microvesicles), moccasins, then serous crusts. At close examination it is possible to reveal numerous dot erosions, on the surface of which small drops of serous exudate "serous wells" protrude. Acute phenomena can subside, then on the red border scales form, and peeling begins. The clinical picture is characterized by polymorphism, representing a colorful pattern of vesicles, crusts, scales.
In chronic course, the red border of the lips and areas of the skin around thicken due to an inflammatory infiltration, the cutaneous pattern intensifies. When the exacerbation of the itching intensifies, there are groups of small bubbles, nodules, crusts, and wetness.
How is eczema recognized on the lips?
Diagnosis of eczematous cheilitis is based on the clinical picture and with classical eczematous lesions of the lips and skin does not cause difficulties.
Differential diagnostics
With isolated lesion, eczematous cheilitis should be distinguished from allergic contact and atonic cheilitis.
Atopic cheilitis is characterized by a predominance of the pattern of infiltration and lichenization of the skin of the corners of the mouth and a prolonged course from childhood.
Allergic contact cheilitis differs more monomorphic flow and terminates after the action of the causative allergen.
[Treatment
Treatment of eczematous cheilitis is complex and involves means of general action:
- antihistamines (clametin, loratadine, desloratadine, etc.);
- preparations of calcium;
- sedatives (phenazepam in small doses, Novo-Passit).
Locally:
- antibacterial ointments based on antibiotics for microbial eczema [gentamycin, chloramphenicol (synthomycin)];
- glucocorticoid ointments [lokoid, mometasone (elokom), methylprednisolone aceponate (advantan), alclomethasone (afloderm), betamethasone (Beloderm)];
- ointments based on naphthalan oil (neftaderm) - with pronounced skin lichenification;
- astringents (cooled lotions of 1% tannin solution) - in the presence of pronounced exudation in the acute period;
- border beams of Bucca (in severe cases, torpid for treatment).
In the treatment of eczematous cheilitis, a hypoallergenic diet is recommended (restriction or complete exclusion of extractives, fungi, meat broths, spices, citrus fruits).
What is the prognosis of eczema on the lips?
The forecast is favorable.