Eczema on the lips (eczematous cheilitis)

Eczema on the lips (eczematous cheilitis) is a chronic recurrent skin disease of a neuro-allergic nature, characterized by serous inflammation of the superficial layers of the skin, itching and arising as a result 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 as a result of the complex effects of neuroallergic, endocrine, metabolic and exogenous factors. Exogenous irritants can be chemical, biological agents, bacterial allergens, physical factors, medications, food products, cosmetics.

Patients with eczematous cheilitis are characterized by the development of polyvalent sensitization, in particular, to dental materials - dental metals, amalgam, plastics, toothpastes, creams, etc. An eczematous reaction is a delayed-type allergic reaction.

Eczema may develop against the background of long-existing cracks in the lips. This type of microbial eczema (peri-wound) reflects the state of skin sensitization to microbial allergens, which is confirmed by skin-allergic reactions with specific antigens. Sensitization to streptococci and staphylococci is most often detected.

Symptoms

Depending on the course of the disease, acute, subacute and chronic eczematous cheilitis are distinguished.

The entire red border of the lips is affected, the pathological process widely spreads to the skin of the face,

Acute eczema on the lips is characterized by itching, severe swelling, hyperemia, the appearance of numerous small bubbles (microvesicles), oozing, then serous crusts. Upon careful examination, numerous point erosions can be detected, on the surface of which small drops of serous exudate "serous wells" appear. Acute symptoms can subside, then scales form on the red border, peeling begins. The clinical picture is characterized by polymorphism, presenting a motley picture of bubbles, crusts, scales.

In chronic cases, the red border of the lips and the skin around it thicken due to the inflammatory infiltrate, and the skin pattern intensifies. During exacerbations, itching intensifies, groups of small blisters, nodules, crusts, and oozing appear.

How to recognize eczema on the lips?

Diagnosis of eczematous cheilitis is based on the clinical picture and does not cause difficulties in the case of classic eczematous lesions of the lips and skin.

Differential diagnostics

In isolated lesions, eczematous cheilitis should be distinguished from allergic contact and atonic cheilitis.

Atopic cheilitis is characterized by the predominance of infiltration and lichenification of the skin of the corners of the mouth and a long course from childhood.

Allergic contact cheilitis is characterized by a more monomorphic course and ceases after the action of the causative allergen.

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Treatment

Treatment of eczematous cheilitis is complex and includes general action agents:

• antihistamines (clemaetine, loratadine, desloratadine, etc.);
• calcium preparations;
• sedatives (phenazepam in small doses, Novo-Passit).

Local:

• antibacterial ointments based on antibiotics for microbial eczema [gentamicin, chloramphenicol (syntomycin)];
• glucocorticoid ointments [lokoid, mometasone (Elocom), methylprednisolone aceponate (Advantan), alklometasone (Afloderm), betamethasone (Beloderm)];
• ointments based on naphthalene oil (neftaderm) - for severe lichenification of the skin;
• astringents (cooled lotions of 1% tannin solution) - in the presence of severe exudation in the acute period;
• Bucca's border rays (in severe cases that are resistant to treatment).

When treating eczematous cheilitis, a hypoallergenic diet is recommended (limiting or completely eliminating extractive substances, mushrooms, meat broths, spices, citrus fruits from food).

What is the prognosis for lip eczema?

The prognosis is favorable.