Overview
Cheilitis glandularis is a chronic inflammatory condition characterized by hyperplasia of minor salivary glands in the lips, often presenting as swelling and sometimes with discharge. 12Diagnosis
Demographics: Predominantly affects females with a mean age around 30-31 years 1.
Types: Common subtypes include endogenous cheilitis (53%), allergic contact dermatitis (34%), and irritant contact dermatitis (5.4%) 1.
Atopy: 33% of patients have a personal history of atopy, with no significant sex difference 1.
Duration: Mean duration of 16.4 months, longer in males (29 months) compared to females (15 months) 1.
Patch Testing: Essential for identifying allergens; mean of 2.8 positive reactions in allergic contact cheilitis 1.
Common Allergens: Lip cosmetics, toothpaste, medicaments, sunscreens, and nail varnish 12.
Irritants: Liplicking frequently causes irritant contact dermatitis 2.Management
Avoidance: Identify and avoid specific allergens and irritants (e.g., lip cosmetics, toothpaste ingredients) 12.
Topical Treatments: Use emollients and topical corticosteroids for inflammation 12.
Patch Testing Follow-Up: Regular follow-up with patch testing to monitor and manage identified allergens 1.
Education: Educate patients on proper lip care and avoidance of irritants 2.
Systemic Therapy: Consider systemic corticosteroids for severe cases, though specific dosing is not detailed 1.
Atopic Management: For atopic eczema contributing to cheilitis, manage underlying atopic conditions 1.Special Populations
Pediatrics: Not specifically addressed in provided abstracts 12.
Elderly: Not specifically addressed in provided abstracts 12.
Comorbidities: Atopic conditions noted in 33% of patients, requiring concurrent management 1.
Pregnancy: Not specifically addressed in provided abstracts 12.Key Recommendations
Perform patch testing to identify specific allergens and irritants in the management of cheilitis (Evidence: Moderate) 1.
Implement strict avoidance strategies based on identified allergens and irritants (Evidence: Moderate) 12.
Consider systemic corticosteroids for severe refractory cases, though evidence is limited (Evidence: Weak) 1.References
1 Lim SW, Goh CL. Epidemiology of eczematous cheilitis at a tertiary dermatological referral centre in Singapore. Contact dermatitis 2000. link
2 Freeman S, Stephens R. Cheilitis: analysis of 75 cases referred to a contact dermatitis clinic. American journal of contact dermatitis : official journal of the American Contact Dermatitis Society 1999. link