Halits

Halits are chronic, more often inflammatory diseases of the lips of different etiology and pathogenesis. Among them, there are diseases in which a change in the lips is only one of the symptoms of known dermatitis. These include atopic cheilitis, eczema of the lips, and others.

Actinic cheilitis is considered a chronic disease of the lips, in which the red border of the lips becomes particularly sensitive to the sun's rays.

Epidemiology

The disease occurs mainly in men aged 20-60 years.

[1], [2], [3], [4], [5],

Causes of the cheilitis

The disease can be considered a weak manifestation of an allergic reaction to ultraviolet rays. In the development of the disease, the state of the gastrointestinal tract and the hepatobiliary system is of great importance.

The development of exfoliative cheilitis is often associated with psycho-vegetative and somatic changes. In this case, there is a violation of trophic connective tissue of the lips, the destruction of the epithelium and the replacement of its fibrous tissue.

[6], [7], [8]

Pathogenesis

In the epidermis, hyperplasia of the epithelium and parakeratosis are observed, in the dermis - edema, dilatation of the blood vessels, in the circumference - inflammatory infiltrate.

[9], [10], [11], [12]

Symptoms of the cheilitis

Actinic cheilitis is most often found in combination with polymorphic photodermatosis, persistent solar erythema. Separately, the disease is rare.

The disease is exacerbated in the spring and summer months, in the autumn and winter months, relapse occurs. If the dermatosis lasts a long time, erosion and deep cracks are formed. In this case, it is necessary to conduct cytological and histological studies, since a prolonged course of actinic cheilitis can subsequently lead to skin cancer or cause other tumors.

There are two forms of the disease: exudative and dry. The dry form of actinic cheilitis mainly develops in early spring. The lower lip turns red, its surface is covered with small, dry, white scales, the focus of the disease occupies the entire surface of the lip. The skin of the upper lip and face is almost not inflamed. Sometimes the lips of the patients are covered with scales, they dry up and there are verrucous tumors.

Exudative form of actinic cheilitis on clinical manifestation becomes similar to acute allergic contact dermatitis.

In this case, the red border of the lower lip swells, reddens, small bubbles appear, which quickly burst and erosion appears. Gradually, the surface of the lip becomes covered with a crust. Patients are troubled by itching, pain and burning.

There are two forms of exfoliative cheilitis - exudative and dry.

In the exudative form on the red border of the lips there appear crusts of grayish-yellowish-brown color. Cork cover with a layer of the red lip rim from the corner to the corner of the mouth and from the red-bordered crayon with the mucous membrane to the middle of the red border. The process never reaches the border of the red border with the skin. If you remove the crust, then a bright red, smooth, slightly moist surface of the lip is exposed. Erosions did not show up. From the side of the mucous lips, there are hyperemia, puffiness, easily removing plaque of white color. Subjectively, burning and pain are noted. The course of the disease is chronic.

In dry form, in the center of the red border, there are densely seated, hardly removable greyish-white scales. Over time, they are easily removed or dropped. Subjectively, dryness and burning lips are noted.

Atopichey cheilitis is one of the symptoms of atopic dermatitis, which causes damage to the red border of the lips and the skin adjacent to it.

Atopic cheilitis is characterized by the lichenification of the red border of the upper and lower lips, especially pronounced in the corners of the mouth. During the exacerbation of atopic dermatitis, in addition to lichenification, there are hyperemia, swelling of the lips, on the surface of which there are cracks and crusts. The process does not capture the entire red border of the lips. But only their outer half, which borders on the skin and spreads from the lips to the skin. As with atopic dermatitis, patients are subjectively concerned about the itching.

[13], [14], [15], [16]

Differential diagnosis

Actinic cheilitis should be distinguished from glandular, atopic, allergic contact dermatitis, B2 hypovitaminosis and cheilitis in case of lupus erythematosus. Atopic cheilitis should be differentiated from red lupus in the red lip rim, eczematous cheilitis (eczema of the lips), exfoliative and contact cheilitis. Eczema of the lips should be distinguished from atopic cheilitis, lesions of the red border of the lips in case of lupus erythematosus, contact cheilitis, actinic cheilitis,

Eczema of the lips occurs in persons suffering from eczema. In this case, puffiness, hyperemia of the lips, vesicular elements and serous wells are noted, with chronic course - lechenization of foci, lesions. Eczema of the lips in children is often complicated by pyococcal infection.

Lip lesion in other dermatoses

With such diseases as psoriasis, red flat lichen, Kaposi's sarcoma, etc., the involvement of the lips in the pathological process is noted. Rashes clinically and morphologically consistent with the underlying diagnosis.

Treatment of the cheilitis

For the treatment of actinic and exfoliative cheilitis, tranquilizers, antidepressants, the main drug - adrenoblockers, nicotinic acid, vitamin A and vitamins of group B (B1, B2, B6, B12) are recommended. You can use anti-febrile drugs (delagil, hingamin). As a topical treatment, corticosteroid ointments and creams, as well as moisturizing fluids, are used. For the prevention and relapse of actinic cheilitis, photoprotective agents can be used.

With eczema of the lips, the main disease is treated. Effective vobenzim, especially in combination with other drugs. As a local treatment, corticosteroids (elokom, advantan) are used.