Introduction: Plasma cell cheilitis (PCC) is a rare, chronic inflammatory dermatitis of unknown etiology. Due to the limited number of cases reported, no guidelines have been established for its treatment. We present a case of PCC clinically similar to actinic cheilitis or mucosal lichen planus, and squamous cell carcinoma but showed response to topical tacrolimus 0.1% ointment. Case Report: A 62-year-old female with extreme fondness to piping hot food presented with a solitary painful ulceration with some pustules and bleeding on the lower lip with three (3) months duration. Skin punch biopsy revealed a dense band-like infiltrate of plasma cells which is consistent with Plasma cell cheilitis. The patient was given tacrolimus 0.1% ointment and showed significant improvement after a month of treatment. Conclusion PCC is a rare condition that should still be considered in patients presenting with persistent cheilitis. Clinical and histological correlation is advised for proper management and prognostication.
cheilitis ; plasma cell ; tacrolimus

Cheilitis ; Humans ; Pemphigus/diagnosis*

Cheilitis is a general term for various types of inflammatory diseases that occur on the lips. The etiology differs and the clinical manifestations and pathological features overlap, leading to difficulties in clinical diagnosis. Reasonable classification is conducive to the diagnosis of cheilitis. However, its classification is difficult because of its cha-racteristics. At present, scholars have proposed two different classification schemes, but a unified classification standard has not yet been established. We classified cheilitis based on its etiology, clinical manifestations, pathological characteristics, and relationship with systemic and special diseases on the basis of special medical reports and by combining clinical practice experience and summarizing previous cheilitis diagnosis and treatment literature. In accordance with this classification method, we proposed suggestions for the clinical diagnosis of cheilitis to provide a reference for the clinical diagnosis and treatment of complex cheilitis.
Cheilitis/diagnosis* ; Diagnosis, Differential ; Humans ; Lip

No abstract available.
Cheilitis ; Methods

Cheilitis granulomatosa (CG) is a subset of orofacial granulomatosis (OFG) and considered to be a monosymptomatic form of Melkersson-Rosenthal syndrome (MRS), which is characterized by the triad of chronic lip swelling, facial paralysis, and fissured tongue. The labial swelling is thought to be associated with an orofacial swelling, which affects the chin, cheeks, and oral mucosa. Histologically, it is distinguished by noncaseating granulomas consisting of lymphohistiocytes and giant cells. Although systemic steroids with or without intralesional triamcinolone injections are the mainstay of treatment, and various agents have been proposed for this rare disease, no successful treatment modality has been reported in the literature yet. Herein, we present our experience with three different CG cases, which showed a varied level of positive response to the combination therapy.
Cheek ; Cheilitis ; Chin ; Facial Paralysis ; Giant Cells ; Granuloma ; Granulomatosis, Orofacial ; Lip ; Melkersson-Rosenthal Syndrome ; Mouth Mucosa ; Rare Diseases ; Steroids ; Tongue, Fissured ; Triamcinolone

Acne vulgaris is a very common condition affecting up of about 80% to 90% of adolescents. The patients with acne have been shown to be adversely impacted by the effect of acne on their quality of life. Four factors are believed to play a key role in the development of acne lesions: excess sebum production, disturbed keratinization within the follicle, colonization of the pilosebaceous duct by Propionibacterium acnes, and the release of inflammatory mediators into the skin. Consequently, the target for acne therapy is these well-known pathogenic factors responsible for this disease state. Topical retinoids correct abnormal keratinization, but it should be applied cautiously because of irritation. Benzoyl peroxide is an effective bactericidal agent against P. acnes. Main topical antibiotics are erythromycin and clindamycin. Fixed combination topical products with retinoids, benzoyl peroxide and antibiotics have been introduced. Use of systemic antibiotics, including tetracyclines and macrolides rapidly improves inflammatory acne lesions. Oral isotretinoin is effective against all of the main pathogenic features of acne but is contraindicated in pregnant women and has been associated with cheilitis and dry skin. Hormonal therapy has been found to improve acne in some selective patients and should be considered for appropriate candidates. This review will present the general aspects of the pharmacological treatments for acne.
Acne Vulgaris ; Adolescent ; Anti-Bacterial Agents ; Benzoyl Peroxide ; Cheilitis ; Clindamycin ; Colon ; Drug Therapy ; Erythromycin ; Female ; Humans ; Isotretinoin ; Macrolides ; Pregnant Women ; Propionibacterium acnes ; Quality of Life ; Retinoids ; Sebum ; Skin ; Tetracyclines

Candidiasis is a common fungal infection that usually affects the oral cavity. It is occasionally difficult to diagnose candidiasis because of its various clinical manifestations. Moreover, chronic inflammation of the lips can obscure clarification of its disease entity in patients with chronic cheilitis. Here we aimed to investigate patients with refractory chronic cheilitis who were initially diagnosed with candidiasis. We screened patients with lip lesions that were clinically suspected to have candidiasis. Our two 65-year-old patients with refractory chronic cheilitis were initially diagnosed with candidal infection. Punch biopsies were performed of the lesions and a diagnosis of actinic cheilitis was made in both patients. Since we did not note prominent improvement after conservative treatment and cryotherapy, we applied 0.015% ingenol mebutate gel for further treatment and then observed significant improvement.
Actins* ; Aged ; Biopsy ; Candidiasis ; Cheilitis* ; Cryotherapy ; Diagnosis ; Humans ; Inflammation ; Lip ; Mouth

BACKGROUND: Plasma cell cheilitis is an unusual benign plasma cell proliferative disease of an unknown etiology that typically presents on the lip. OBJECTIVE: The aim of this study was to investigate the clinicopathological characteristics of 13 cases of plasma cell cheilitis. METHODS: The present study investigated the clinical manifestations, treatment modalities, and outcome of 13 patients diagnosed with plasma cell cheilitis from 2011 to 2016 at Kangdong Sacred Heart Hospital and Hallym University Sacred Heart Hospital. Biopsy specimens of the all cases were evaluated using conventional hematoxylin and eosin staining with kappa and lambda immunoglobulin light chain immunohistochemistry. RESULTS: The age of the patients ranged from 39 to 86 years (mean, 64.7 years), with male predominance. Histopathologically, 61.5% and 38.5% of patients showed band-like and pan dermal plasmacytic infiltrates, respectively. Eosinophilic infiltration was noted in 69.2% of patients. All cases showed both kappa and lambda immunoglobulin light chain reactivities, and kappa predominance was confirmed in 9 patients (69.2%). A majority of the patients was treated with local therapy, such as intralesional steroid injection with topical tacrolimus. Among the 13 patients, plasma cell cheilitis completely resolved, partially resolved, and recurred in 3 (23.1%), 5 (38.5%), and 5 patients (38.5%), respectively. CONCLUSION: Plasma cell cheilitis presented as erosive edematous circumscribed patches or plaques affecting mainly the lower lip of elderly male patients. The majority of histopathology cases showed characteristic plasma cell aggregation on the upper dermis that was immunopositive for immunoglobulin light chain, with kappa predominance.
Aged ; Biopsy ; Cheilitis* ; Dermis ; Eosine Yellowish-(YS) ; Eosinophils ; Heart ; Hematoxylin ; Humans ; Immunoglobulin lambda-Chains ; Immunoglobulin Light Chains ; Immunohistochemistry ; Lip ; Male ; Plasma Cells* ; Plasma* ; Tacrolimus

BACKGROUND: There have been many changes to the social and medical environment in Korea and many studies showed a steady increase of cutaneous tumors. But none of them included a data occurring from head and neck. OBJECTIVE: To investigate the incidence and distribution of the cutaneous tumors of the head and neck. METHODS: A total of 1,415 cases of head and neck cutaneous tumors were obtained from pathology specimen at Department of Dermatology between 2010 and 2014. RESULTS: Among 1,415 cases of head and neck cutaneous tumors, 871 cases (61.5%) were benign tumors, 271 cases (19.2%) were malignant tumors, and 273 cases (19.2%) were premalignant lesions. The most common benign head and neck cutaneous tumors was epidermal cyst with 188 cases (21.6%), followed by 173 cases (19.9%) of seborrheic keratosis, 71 cases (8.2%) of intradermal nevi. Among the 271 cases of malignant head and neck cutaneous tumors, there were 164 cases (60.5%) of basal cell carcinoma, 89 cases (32.8%) of squamous cell carcinoma, 5 cases (1.8%) of malignant melanoma. The predilection sites of malignant head and neck tumors were face (87.5%), ear (4.8%) and neck (4.0%). Of the premalignant lesions, there were 210 cases (76.9%) of actinic keratosis, 36 cases (13.2%) of Bowen's disease and 27 cases (9.9%) of actinic cheilitis. CONCLUSION: In our study, the proportion of malignant tumors and premalignant lesion in head and neck tumors was higher than previous reports. Also, the percentage of woman in malignant tumors and premalignant lesions was higher than man, unlike previous studies. However, these results had limitation associated with retrospective study in a single institution, and further prospective study with multi-center is required for confirmation.
Actins ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheilitis ; Clinical Study* ; Dermatology ; Ear ; Epidermal Cyst ; Female ; Head* ; Humans ; Incidence ; Keratosis, Actinic ; Keratosis, Seborrheic ; Korea ; Melanoma ; Neck* ; Nevus, Intradermal ; Pathology ; Prospective Studies ; Retrospective Studies

BACKGROUND: The oral mucosa is constantly exposed to several irritants and allergens including dental materials, but the role of contact allergy in oral disease is obscure. OBJECTIVE: To analyze positive patch test results in patients with oral diseases and evaluate the clinical relevance of oral diseases with contact allergy to dental materials. METHODS: We retrospectively analyzed patch test results with dental screening series in 44 patients with oral disease from 2004~2011. RESULTS: Oral diseases included oral lichen planus (54.5%), cheilitis (27.3%), burning mouth syndrome (9.1%), and others (9.1%). Thirty-one of 44 patients (70.5%) had positive reactions to one or more allergens. The most commonly detected allergens were gold sodium thiosulfate (25.0%) and nickel sulfate (25.0%), followed by potassium dichromate (22.7%), cobalt (15.9%), palladium (6.8%), mercury (4.5%), copper (4.5%), and methylhydroquinone (4.5%). Six of 24 patients with oral lichen planus had a symptom in areas adjacent to dental materials and positive patch test reactions to allergens contained in the suspected dental materials. CONCLUSION: Patch tests with dental screening series are worth considering for oral diseases, especially for oral lichen planus.
Allergens ; Burning Mouth Syndrome ; Cheilitis ; Cobalt ; Copper ; Dental Materials ; Gold Sodium Thiosulfate ; Humans ; Hypersensitivity ; Irritants ; Lichen Planus, Oral ; Mass Screening* ; Mouth Mucosa ; Nickel ; Palladium ; Patch Tests* ; Potassium Dichromate ; Retrospective Studies