Cheilitis
Description:
The term "cheilitis" call an inflammation of lips (a red border, a mucous membrane and skin).
Cheilitis symptoms:
Usually process is localized on a red border of lips, sometimes slightly extends to skin of lips. Less often also the mucous membrane of a mouth, perhaps isolated damage of a mucous membrane of lips are surprised.
On site contact with allergen quite sharply delimited erythema develops and the insignificant peeling is noted. At the long course of a disease the red border of lips becomes dry and on it cross small grooves and cracks appear. At a number of patients the disease proceeds with the expressed ostrovospalitelny reaction against the background of which there can be small bubbles which are quickly opened and forming the limited becoming wet sites. Patients complain of an itch and burning of lips.
Allergic cheilitis, especially at the expressed peeling of lips, it is necessary to distinguish from a dry form of an exfoliative cheilitis at which there is no erythema, defeat is localized strictly from Klein's line to the middle of a red border, never takes all surface of a red border or skin of a lip.
Primary glandulyarny cheilitis has a typical clinical picture. In the field of transition of a mucous membrane to a red border of a lip, and sometimes on a red border expanded mouths of sialadens in the form of red points from which saliva droplets are allocated are visible. In 20-30 sec. after drying of a lip the wooden pallet salivation from mouths of sialadens clearly is noticeable, and saliva as dew drops, covers a lip.
The lip at patients with a glandulyarny cheilitis is periodically moistened with saliva which evaporates therefore the red border becomes dry, begins to be shelled. On this background cracks, erosion, and also various forms of a precancer can develop.
The secondary glandulyarny cheilitis is a consequence of chronic inflammatory diseases at which the mucous membrane or a red border of lips can be affected (red flat deprive, a lupus erythematosus, etc.). Apparently, the inflammatory infiltrate which is available at these diseases irritates ferruterous fabric and causes its hyperplasia with hyperfunction. In this case against the background of a clinical picture of a basic disease on a lip expanded mouths of sialadens from which saliva droplets are allocated are found.
The actinic cheilitis (cheilitis actinica) represents a chronic disease which is caused by hypersensitivity of a red border of lips by a sunlight.
The actinic cheilitis meets more often at men of 20-60 years. Distinguish 2 forms of a disease - exudative and dry.
In spring season the red border of an under lip at a dry form of an actinic cheilitis becomes bright red, becomes covered by small dry silver-white scales. The upper lip and face skin are surprised extremely seldom. At certain patients on a red border sites of keratinization, and sometimes verrukozny growths are formed. The clinical picture of an exudative form of an actinic cheilitis represents clinic of acute allergic contact dermatitis. At the same time against the background of slightly edematous red border of an under lip there are sites of a bright red erythema, sometimes on an edematous and hyperemic red border there are small bubbles which are quickly opened and turning into erosion on which surface crusts are formed.
Patients are disturbed by an itch, burning, morbidity of lips is more rare. Seasonality of a current is characteristic: an exacerbation of a disease during the spring and summer period and spontaneous regression in autumn and winter. At long existence of an actinic cheilitis the red border becomes inclined to keratinization, on it there can be cracks, and in some cases erosion and ulcers. It is long not healing erosion, cracks and ulcers, especially with consolidation in the basis, and also sites of the expressed keratinization or warty growths have to be subjected to an obligatory cytologic or histologic research for an ozlokachestvleniye exception. The actinic cheilitis can serve as a background for development of obligate forms of a precancer.
The atopic cheilitis differs from an allergic contact cheilitis in infiltration (likhenizatsiy) red border and skin of lips which is especially expressed in mouth corners, current duration.
Cheilitis reasons:
The red border, mucous membrane and skin of lips can be involved in pathological process at many dermatosis: eritematoza, red flat herpes, psoriasis, tuberculosis, syphilis, etc.
The simple cheilitis can be caused by action of adverse meteorological factors, first of all cold or hot air (wind), excessive insolation, etc. Develops usually at the persons working in the open air. This form is called a meteorological cheilitis.
The allergic cheilitis develops as a result of a sensitization of a red border of lips, is more rare than a mucous membrane of lips to chemicals, UV rays, etc. The vast majority of patients with an allergic cheilitis make women aged from 20 up to 60 years. The disease can have also professional character.
Generally lipsticks, because of the fluorescent substances entering them, and also eosine, rhodamine, etc. are the reason of allergic heylit that explains a preferential disease of an allergic cheilitis of women. The plastic of dentures, dyes entering them, aromatic substances - components of denture powders and pastes, plastic mouthpieces of wind instruments can be the cause of an allergic cheilitis and stomatitis.
Treatment of the Cheilitis:
Treatment of a glandudyarny cheilitis. In therapy of a glandulyarny cheilitis use antiinflammatory ointments (tetracycline, erythromycin, and also Flucinarum and Synalarum, oxolinic ointment, etc.). However the most justified method is electrothermic coagulation of hypertrophied sialadens or enucleating in their surgical way. Use of laser ablation with use of the surgical laser is successful. For the purpose of prevention sanitation of an oral cavity, dryness elimination, a moknutiya of lips, normalization of a microbic landscape of an oral cavity and medical examination of patients are necessary.
Treatment of an atopic cheilitis. In treatment of an atopic cheilitis the principal value gets establishment and elimination of an irritant. Locally use the ointments containing the hormones possessing antiallergic, antipruritic and antiinflammatory action (Flucinarum, prednizolonovy, Ftorokortum and other ointments). Besides, carry out antiallergic therapy, appoint inside tavegil, Phencarolum, кларитин or other drugs. In a diet exclude the substances causing a sensitization: caviar, chocolate, strawberry, citrus and other fruit, and also spicy and spicy food.
Treatment of a meteorological cheilitis. Treatment of a meteorological cheilitis includes first of all the termination of an adverse effect of solar radiation or other meteorological factors. Locally use ointments with hormones (hydrocortisone, prednizolonovy, etc.). Apply protective creams from ultraviolet radiation. Inside appoint vitamins of group B, PP, etc.
Treatment of a macrochilia. In treatment of a macrochilia the main role belongs to a combination of the immunokorregiruyushchy, desensibilizing and antiviral therapy. Appoint hormones (dexamethasone), Oxytetracyclinum, antiallergic drugs - tavegil, Suprastinum. Vitamins C, B, PP. Immunoproofreaders - ликопид, etc. Antiviral - бонафтон, an acyclovir, zovirax, лейкинферон. A certain effect use laser therapy on area of lips and zones of defeat possesses neuritis of a facial nerve. At resistant forms during remission carry out the stimulating therapy by pyrogenal, Prodigiosanum and other drugs. At neuritis use physical factors, Bernard's currents, ultrasound, etc. The good result is received from an electrophoresis of Unguentum Heparini or its applications on the bay together with Dimexidum. At detection of hypersensitivity apply specific desensitization to bacterial allergens bacterial allergens. With the cosmetic purpose use surgical excision of a part of the bay, however it does not prevent a recurrence. Recently there were messages on effective use of a girudoterapiya (medical bloodsuckers). The forecast - at the timely address to the doctor and adequate therapy - favorable.
