Cheilitis is a general medical term that refers to the inflammation of the lips. This condition can manifest in various forms, ranging from mild, transient irritation to severe, persistent inflammation that significantly impacts a person's quality of life. The inflammation can affect any part of the lips, including the vermilion border (the red part of the lip), the surrounding skin, and the oral mucosa. The condition is not contagious in itself, although some of its causes, like viral infections, can be.
Can a dermatoscope help diagnose cheilitis?
Dermoscopy, applied to the lip surface as mucoscopy, enhances the diagnostic process of cheilitis by revealing subsurface patterns that are not discernible on routine inspection. In actinic cheilitis, the presence of a whitish-red background combined with scale and variable vessel morphology is associated with dysplastic change. Dermoscopy therefore serves not only to confirm the extent of field damage but also to guide the selection of the most atypical site for targeted biopsy, a step that has been shown to improve histological concordance and reduce sampling error.
During subsequent management—whether with topical 5-fluorouracil, imiquimod, or laser ablation—serial dermoscopic images provide an objective correlate of clinical response; disappearance of keratinised white structures and normalisation of vascular architecture precede complete clinical clearing and can prompt timely cessation or modification of therapy, thereby limiting unnecessary morbidity.
What new accessories will IBOOLO be launching recently?
IBOOLO will soon launch a contact plate without glass. Once this accessory is available, users will be able to use it to perform non-contact dermatoscopy on patients. Non-contact dermatoscopy means that no pressure is applied to the skin lesion being observed during the examination, thereby avoiding pain for the patient. It is also ideal for examining infected areas, as it effectively prevents cross-infection.
What are the common symptoms of cheilitis?
The clinical presentation of cheilitis is highly variable, but several common symptoms and visual characteristics are frequently observed across its different forms. These signs are the result of the underlying inflammatory process and can range from subtle changes to overt lesions. The most common symptoms include redness (erythema), swelling (edema), and dryness of the lips. These initial signs often progress to more severe manifestations if the underlying cause is not addressed. For example, the skin of the lips may become scaly, leading to peeling and flaking. In more advanced cases, painful cracks or fissures can develop, particularly at the corners of the mouth, which can bleed and become crusted. The texture of the lip surface may also change, becoming rough or "sandpapery" to the touch, especially in conditions like actinic cheilitis. In addition to these physical changes, patients often report subjective symptoms such as itching, burning, or a sensation of tightness, which can be both uncomfortable and distressing.
What are the different types of cheilitis?
Cheilitis is best classified according to duration and reversibility into three main groups: largely reversible, predominantly irreversible, and lesions secondary to dermatoses or systemic disease. The first group comprises entities such as angular, contact/eczematous, exfoliative and drug-related cheilitis, which usually remit once the precipitating factor is removed. The second encompasses chronic forms—actinic, granulomatous, glandular and plasma-cell cheilitis—that tend to persist, often require biopsy for confirmation, and carry a measurable risk of malignant progression. The third category includes lip inflammation occurring as a manifestation of systemic disorders such as discoid lupus erythematosus, lichen planus, pemphigus vulgaris or nutritional deficiency states.
What are the causes of cheilitis?
The aetiology of cheilitis is multifactorial. Chronic ultraviolet exposure initiates actinic cheilitis through accumulation of p53-mutated keratinocytes, while repeated contact with irritants or allergens precipitates eczematous or allergic contact variants. Angular cheilitis frequently arises from combined candidal or staphylococcal infection superimposed on mechanical factors such as saliva pooling, ill-fitting dentures, or deficiencies of iron and B-complex vitamins. Systemic retinoids and other xerostomia-inducing drugs produce a characteristic drug-induced cheilitis, whereas granulomatous inflammation may reflect underlying Crohn disease, sarcoidosis or the idiopathic Miescher syndrome. Less commonly, leishmaniasis in endemic regions or chronic bacterial infection of minor salivary glands produces glandular cheilitis characterised by tumefaction and suppuration.
How to treat cheilitis?
Treatment is dictated by the underlying cause. Reversible forms respond to elimination of the trigger combined with protective measures: bland emollients for simplex cheilitis, topical antifungals or antibiotics for angular cheilitis, and withdrawal of the offending agent plus low- to medium-potency corticosteroids for contact or drug-related disease. Persistent actinic cheilitis requires field-directed therapies such as 5-fluorouracil, imiquimod, cryotherapy, laser ablation or vermilionectomy to prevent squamous cell carcinoma. Granulomatous and glandular variants may necessitate intralesional or systemic corticosteroids, long-term antibiotics, or surgical excision when conservative measures fail. In every instance, associated systemic conditions—nutritional deficiencies, diabetes mellitus, or autoimmune disease—must be identified and corrected to reduce recurrence.