This document discusses various diseases that can affect the lips. It describes conditions like angular cheilitis, lip fissures, allergic cheilitis, actinic cheilitis, exfoliative cheilitis, perioral dermatitis, lick eczema, and cheilocandidiosis. For each condition, it covers causes, symptoms, diagnosis, and management approaches. The document is intended to describe the different lip diseases that can occur so the reader understands which conditions to consider based on a patient's presentation.

1. Dr. ShahzaD Hussain
BDS, FCPS(r)
Oral & Maxillofacial Surgery
Nishtar Institute Of Dentistry, Multan
SNDENTALCARE.CO

2. Diseases OF Lips??
Any Idea??...

3. Learning Outcomes?
 At the End oF this Discussion we will be able to Describe
 Which are the Diseases Of the Lips??
1. Swelling?
 Generalized
 Localized
1. Angular Cheilitis?
2. Lip Fissures?
3. Allergic Cheilitis?
4. Actinic cheilitis?
5. Exfoliative
6. Perioral Dermatitis?
7. Lick Eczema?
8. Cheilocandidiosis

4. Swelling Of Lips?
 Swelling of lips
 It May be
1. Generalized/Diffuse
2. Localized
 Usually involves Perioral area of skin
 Usually patients of Orofacial Granulomatosis and
angioedema present with lip swelling.

5. Causes Of lip Swelling
DIffuse Localized
1. Angioedema
2. Oedema
3. OFG
4. Crohn’s Disease
5. Haemengioma
6. Lymphangioma
1. Mucocele
2. Abscess
3. Haematoma
4. Salivary adenoma
5. Basal Cell Carcinoma
6. Squamous cell carcinoma
7. Keratoacanthoma

9. Angular Cheilitis
 Angular Chelitis is the Inflammation of one or both
corners of mouth
 Multifactorial disease
 with
1. Local
2. Systemic factors

10. Inadequate
Dentures
• Skin creasing with sliva
leakage and maceration
at corners of the mouth
• Host Defences
Compromised
Systemic
Diseases or
Deficiencies
• Anemia
• Iron Deficiency, B12 or
Folate Deficiency
• HIV
• Diabetes Mallitus
• Sjogresn’s Syndrome
Trauma
• S. Aureus Species
• Candida Species

11. Diagnosis?
1. Complete Medical, social, Dental History
2. Complete Examinations Especially for anemia, ill
fitting denture, denture and candidial infections.
3. Investigations?
1. Microbilogical:
1. Sampling? Smear, swab, oral rinse
2. Site? Angle, palate, fitting surface of denture
Blood Tests:
Complete Blood Count
Serum B12, ferritin, serum and red cell folate levels

12. Management
 Elimination of local factors
 Denture Hygiene
 Instruct patient to leave denture at night
 Referral to medical specialist for underlying medical
cause
 Provision of antimicrobial therapy
1. Local
2. Systemic

13. Antimicrobial therapy
 Candida isolated
1. Nystatin pastilles (intraoral)
2. Nystatin ointment (corners)
 S. aureus isolated
1. Fusidic acid cream (angles)
2. Mupirocine cream/fusidic acid cream (anterior
nares)
 Mixed infection
1. Miconazole gel/cream
 Chlorhexidine mouthwash

14. Lip Fissures
 Less common
 Midline of lower lip
 Resistant to conservative treatment usually
 Majority of these is due to Infections which may be
S.aureus or candida albicans
 Treatment principle is based on elimination of secondary
cause of infection and then topical steroid Creams
application.
 Recurrence is common
 Commonly seen in patients of down syndrome along with
angular cheilitis as well as OFG

16. Allergic Chelitis
 Irritation and scaling of lips caused by allergy due to
1. Lipsticks
2. Ointments
3. Foods
4. Moisturizes
5. Tooth pastes
6. Lipstick allergy may also be caused by straw sharing and
kissing
Mangement:
1. Identification and removal of the cause of irritation
2. Topical steroids cream can be used for short term
management

18. Actinic Cheilitis
 Solar keratosis
 predominantly male patients
 Prolonged exposure to sunlight either occupational or
recreational may result this
 Long exposure to sunlight
 Lower lip more effected
 Crusting and induration of the vermilion margin
 May progress to carcinoma
 Biopsy is necessary for complete assessment

19.  Epithelial atypia is seen in this condition
 Crusting and induration is due to fibrotic reaction of
the connective tissues.
 Treatment :
1. Excision by either lip shave operation
2. laser treatment

20. Exfoliative Chelitis
 Production of excess amount of keratin
 Involves vermilion border
 Brown scales are formed which may be removed by the patient or
may persist
 Reported to be exclusively in females
 Histology is simply hyperparakeratosis
 Not a malignant condition
 May be related to stress, no definite cause is known
 Various treatments have been used like local and systemic steroids,
cautery, cryosurgery and many others but all without success.
 Antidepressants have also been used with some success reported.
 Resolves itself usually.

22. PeriOral Dermatitis
 Relatively unommon
 Young adult females
 Erythematous rash on the facial skin around the
mouth
 Can be due to previous use of steroid creams or contact
allergy
 Clinical diagnosis
 Treated with low potency steroid like 1%
hydrocortisone
More tan one aetiological factor may be involved.

24. Lick Eczema
 Young children
 Sharply deliniated zone of irritable scaly skin around
the mouth
 Treatment is to stop the habit of licking
 Removable appliance

27. Cheilocandidosis
 Heavy candidial infection
 Bilaterally
 Lower lip
 Ulcerated granular areas
 Generally healthy patients with a previous history of
local abnormality.
 Early treatment with anti fungals is necessary.