Cheilitis contact allergicK13.0

Allergic, acute, sub-acute or chronic contact dermatitis of the lip. Allergic contact dermatitis of the lip can occur with or without accompanying contact stomatitis (see below contact allergic stomatitis).

Triggering allergens are various external agents such as ointments against herpes simplex infections(Tromantadin, Idoxuridin, Trifluridin, Aciclovir, Penviclovir), lip care products, cosmetics (lipsticks). Furthermore there are fragrances, nail varnish components (car transfer by nail biting), nickel, gum (nervous chewing on corresponding products.

Depending on the acuity, contact allergy of the lips is characterized by redness, a feeling of tension, oedema, blistering and crust formation. The clinical picture of "lip eczema" is divided into two parts, depending on whether the skin of the lips or the red of the lips is also affected or only in isolation. In most cases, contact-allergic lip eczema affects both the red of the lips and the lip skin. The clinical picture manifests itself at the red of the lips by a feeling of tension, possibly even pain, swelling, parchment-like aspect of the epidermis, possibly with transverse rhagade formation.

The skin of the lips shows blurred swelling, redness, scaling, possibly with blisters and erosions. The clinical picture is often chronic with lichenification of the lip skin, scaling, erosion and rhagade formation.

Medical history and epicutaneous testing. An epimucosal test is not necessary, since a clinically relevant contact allergy of the oral mucosa can also be detected on the skin.

• Acute: Short-term glucocorticoid-containing low-concentration topicals such as 0.5% hydrocortisone ointment and moist pads with physiological saline solution or black tea. However, there is no contraindication against the short-term use of a topical Class III glucocorticoid externa (preferably in a non-preserved ointment base).
• Intermediate testing, then further treatment with well tolerated base.
• Chronic: Short-term glucocorticoid-containing low-potency topical preparations such as 0.5% hydrocortisone cream.
• After-treatment with well tolerated fatty base (e.g. Vaselinum album).

1. Aguirre A et al (1993) Edematous allergic contact cheilitis from a toothpaste. Contact Dermititis 28: 42
2. Athavale NV et al (1994) Contact cheilitis from propyl gallate in lipstick. Contact dermatitis 30: 307
3. Ichihashi K et al (2003) Allergic contact cheilitis from pentaerythritol rosinate in a lipstick. Contact dermatitis 49: 213
4. Raison-Peyron N et al (2003) Bromelain: an unusual cause of allergic contact cheilitis. Contact dermatitis 49: 218-219
5. Schuster C et al(2012) Pitfalls of patch testing with dental materials. Br J Dermatol 166:674-675
   .Schütz KD et al. (1994) Contact dermatitis caused by prednicarbate in cheilitis. Act Dermatol 20: 22-24