Cheilitis: treatment with physical factors. Cheilitis (actinic, glandular, exfoliative, allergic, atopic, eczematous, meteorological, angular and candidal)

Etiology and pathogenesis. Eczema of the lips is a manifestation of a general eczematous process, i.e. a disease that L.N. Mashkilleyson defined as inflammation surface layers skin of a neuro-allergic nature, resulting from the action of external and internal irritants and clinically manifested mainly by redness and blisters, accompanied by itching, histologically - spongiosis with the formation of blisters in the spinous layer of the epidermis. In this case, allergens can be the most various factors, such as microbes, nutrients, various medications, metals such as nickel and chromium, materials used for the manufacture of dentures, amalgam used for filling teeth, toothpaste etc.

Clinical picture. Eczema of the lips, like eczema in general, can be acute, subacute or chronic. In this case, damage to the red border of the lips can be combined with damage to the skin of the face or be isolated.

Clinical picture acute eczema lips is characterized by polymorphism: redness, small nodules, blisters, scales and crusts appear successively. The process is accompanied by significant swelling of the lips. It is very characteristic that even in cases where the eczematous process occurs isolated on the lips, it still at least slightly affects the skin adjacent to the red border. It should be noted that the polymorphism observed during the eczematous process is mainly of an evolutionary nature, in other words, not all elements appear at once, and some rashes are formed from others.

The process begins with redness and swelling of the red border of the lips (both lips are almost always affected at once). If the process does not progress further, then soon scales form on the red border and peeling begins. In other cases, small nodules form on the hyperemic and edematous red border, some of which quickly turn into vesicles, most of which open and weeping occurs, accompanied by the formation of crusts, sometimes quite massive. This condition can develop very quickly, sometimes within a few hours. Patients are bothered by itching and burning, and find it difficult to open their mouth and talk. Subsequently, the acute phenomena gradually subside, weeping, swelling and hyperemia sharply decrease, but if the effect of the allergen is not eliminated, then the first outbreak is followed by a second, third, and the process on the lips becomes chronic.

At chronic course eczematous process, the clinical picture changes. The red border of the lips and areas of affected skin around the mouth thicken due to the formation of an inflammatory infiltrate. Sometimes the infiltration of the red border and skin is so significant that the skin pattern becomes clearly defined. On this basis, in some places small groups of small nodules, vesicles, crusts are located, scales are formed, and sometimes when the process worsens, weeping occurs. Often this condition is complicated by the formation of painful, sometimes bleeding cracks. Patients are bothered by itching.

In some patients, eczema develops on completely unchanged lips; much less often, the onset of the eczematous process is preceded by long-term microbial cracks in the lips. In these cases, developing lip eczema is usually considered to be microbial eczema. Thus, with microbial eczema of the lips, a microbial jam or microbial crack first appears in the center of the lip, less often at the wings of the nose. As a result of sensitization of the skin or red border surrounding these lesions to bacterial toxins and autotoxins, microbial eczema. In this case, the red border and surrounding skin, most often only the lip on which the microbial focus is located, swell, turn red, then small vesicular elements form, quickly drying into yellowish or yellowish-gray crusts. The eczematous reaction is especially pronounced near the microbial focus. The rash of vesicular elements stops quite quickly, and peeling occurs. In this state the process can continue long time.

Microbial eczema is rare. The isolated form of idiopathic eczema of the lips, although observed more often than microbial eczema, is significantly inferior in frequency to atopic cheilitis.

Diagnosis of lip eczema is made easier by the fact that there is usually a classic eczematous skin lesion at the same time. In other cases, the diagnosis of lip eczema is based on the presence of microvesiculation, pinpoint serous “wells,” pinpoint weeping without preliminary scratching, as well as evolutionary polymorphism of rashes. With eczema of the lips, you can simultaneously see rashes characteristic of various stages eczematous process.

Eczema of the lips is most similar to allergic contact and atopic cheilitis. However, the latter usually occurs in childhood, with it there is no microvesiculation and pinpoint serous “wells”, a different nature of skin lesions is noted, in the clinical picture of lip lesions the phenomena of lichenization prevail, mainly in the corners of the mouth, where the process always spreads to the skin. With allergic contact cheilitis, in contrast to eczema of the lips, the process has a monomorphic character, i.e. in all areas of the red border it is in the same stage, usually does not spread to the skin, and quickly resolves after the cessation of the action of the sensitizer (allergen). The exudative form of actinic cheilitis differs from eczema of the lips in the seasonality of its occurrence and the clear connection of the disease with insolation.

Treatment. Pathogenetic treatment of eczema consists of the use of desensitizing and sedatives.

Local therapy for lesions on the lips consists of prescribing ointments containing corticosteroids, and in case of weeping, aerosols with corticosteroids. For microbial eczema, ointments and aerosols containing corticosteroids and antibacterial substances (Lorinden S, Dermozolon, Oxycort in the form of an aerosol, etc.) are indicated.

What is Eczematous cheilitis
Treatment of Eczematous Cheilitis

What is Eczematous cheilitis

Cheilitis- benign inflammatory disease lips There are two groups of cheilitis: cheilitis itself and symptomatic cheilitis.

The group of cheilitis proper unites independent diseases lips of various etiologies. These include exfoliative cheilitis, glandular cheilitis, meteorological and actinic contact cheilitis. The second group - symptomatic cheilitis - includes lesions of the lips, which are a symptom of diseases of the oral mucosa, skin, and general somatic diseases. The group of symptomatic cheilitis includes atopic cheilitis, eczematous cheilitis, macrocheilitis in Melkerson-Rosenthal syndrome.

Eczematous cheilitis (cheilitis eczematosa) also applies to symptomatic diseases lips, since it manifests itself as a symptom of a general eczematous process, which is based on inflammation of the superficial layers of the skin of a neuroallergic nature.

Allergens can be various factors: microorganisms, food substances, drugs, materials for the manufacture of prostheses, metals such as nickel and chromium, amalgam, filling materials etc.

Symptoms of Eczematous cheilitis

Eczematous cheilitis, like any eczema, can occur acutely, subacutely or chronically. Damage to the red border of the lips can be combined with lesions of the facial skin or be isolated.

The acute stage of the disease is characterized by polymorphism: vesicles, oozing, crusts, scales. The process is accompanied by significant swelling of the lips. At this stage of the disease, patients complain of itching, burning in the lips, swelling and hyperemia. The spread of the process to the skin adjacent to the red border is very typical.

Transition of the disease to chronic form characterized by a decrease in inflammatory phenomena (edema, hyperemia). The red border of the lips and areas of affected skin around the mouth thicken due to inflammatory infiltration, nodules and scales appear. The eruption of vesicles stops and desquamation occurs. In this state, the process can continue for a long time. All described clinical symptoms eczematous cheilitis develops on unaltered lips.

Sometimes the onset of an eczematous process is preceded by long-existing microbial jams and cracks. In these cases, developing lip eczema is usually considered as microbial sensitization of the red border of the lips or skin. Clinical manifestations of microbial eczema on the red border of the lips are completely identical to the described clinical picture of eczematous cheilitis. A feature of microbial lip jamming is a more pronounced eczematous reaction near the microbial focus.

Diagnosis of Eczematous cheilitis

Eczematous cheilitis differentiated from:

atopic cheilitis;
allergic contact cheilitis;
exudative form of actinic cheilitis.

Treatment of Eczematous Cheilitis

Complex therapy of eczematous cheilitis is based on the nature of its clinical manifestations(stage, severity, prevalence of the process), mechanisms of development of an allergic reaction and features of the pathology of internal organs.

Hyposensitizing therapy is prescribed (suprastin, diazolin, tavegil, fenkarol, etc.), calcium, sodium preparations (10% calcium chloride solution or 30% sodium thiosulfate solution is administered intravenously, 2-10 ml, for a course of 20 injections).

At acute stage diseases and significant prevalence of the lesion, corticosteroid drugs are used in low doses (Presocil).

Among the sedatives used are preparations of bromine, valerian, motherwort, tranquilizers and antipsychotics (Elenium, Seduxen, Tazepam, Amizil, Oxylidine, etc.).

According to indications and taking into account tolerability, vitamin therapy is prescribed (A, B1, B2, B6, B12, B.5, E, K, C, folic, nicotine and orotic acid, pangamate and calcium pantothenate).

Local treatment consists of prescribing ointments containing corticosteroids, and in the presence of oozing, aerosols with corticosteroids are used. For microbial eczema, ointments and aerosols containing corticosteroids and antimicrobials(“Lorinden S”, “SinalarN”, aerosols “Dexon”, “Dexocort”, “Locacorten”, 0.5% prednisolone ointment, etc.).

Which doctors should you contact if you have Eczematous cheilitis?

Dentist
Allergist
Infectious disease specialist
Dermatologist

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Eczema of lips is a manifestation of a general eczematous process, i.e. disease that A.L. Mashkilleyson defined it as an inflammation of the superficial layers of the skin of a neuro-allergic nature, resulting from the action of external and internal irritants and clinically manifested mainly by redness and blisters, accompanied by itching. Histologically - spongiosis with the formation of vesicles in the spinous layer. In this case, allergens can be a variety of factors: microbes, food substances, various medications, metals such as nickel and chromium, prosthetic materials, amalgam, toothpaste, etc.

Clinic. The disease can occur acutely, subacutely and chronically. In this case, damage to the lips can be combined with damage to the skin of the face or be isolated.

For acute eczema polymorphism of the lesion elements is characteristic: redness, small blisters, filled serous exudate yellow. The bubbles merge with each other, burst and become wet. Ring-shaped scales and crusts appear (Fig. 11).

Rice. 11.

The rash is accompanied by itching and swelling of the lips. The process quickly spreads to the skin adjacent to the border and the corners of the mouth.

With transition acute course in chronic conditions, hyperemia, swelling and weeping decrease. The red border and areas of skin lesions around them become denser due to the inflammatory infiltrate, become hyperemic, peel, cracks and bloody crusts are visible in places. The disease lasts for years and often worsens.

Differential diagnostics- eczematous cheilitis is differentiated from contact allergic cheilitis by the exudative form of actinic cheilitis.

Treatment: is based on the principles of treating skin eczema. Hyposensitizing, sedative, and vitamin therapy are carried out.

Locally: corticosteroid ointments, in case of weeping - corticosteroid aerosols.

Melkersson syndrome - Rosenthal. This is a symptom complex, which is characterized by a combination of recurrent swelling of the lips, recurrent one or less bilateral paresis facial nerve and folded tongue. The etiology of the syndrome has not been fully elucidated. Most likely it is of infectious-allergic origin, perhaps a consequence of vasomotor disorders in neurodystrophic disorders. A number of authors consider the disease to be constitutional and hereditary.

Symptoms of the disease do not appear simultaneously. Both swelling of the lips and paresis of the facial nerve occur suddenly and then recur. A shapeless swelling of the lip or both lips occurs (Fig. 12).

Rice. 12.

The edge of the lip often turns out in the form of a proboscis and lags behind the teeth (Fig. 13).

Fig. 13.

The thickening is uneven. The color of the lip is pale red, sometimes with a bluish tint. Cracks may appear on the s/c. On palpation, the lips have a soft consistency, without infiltration in the depths of the lesion. Acute edema after some time (from 3-6 days to a month) it subsides, but relapses are repeated and with each crisis an increasing thickening of the lips is noted. A folded tongue occurs in only half of the cases (Fig. 14).

Rice. 14 Folded tongue: against the background of the tongue papillae and dry crimson mucous membrane, longitudinal folds are visible

Treatment. The success of treatment depends on identifying the genesis pathological changes. Treatment is carried out in two directions - conservative and surgical. Best results gives combined treatment with corticosteroids (20-30 mg), a/b wide range action, synthetic antimalarial drugs (hingamin 0.25 x 2 rubles) and hyposensitizing drugs (calcium, antihistamines) 30-40 days. The course is repeated after 3 months. At surgical treatment Some lip tissue is removed, although this does not prevent recurrence.

Precancerous diseases of the oral mucosa and red border of the lips

Precancerous diseases- one of current problems modern theoretical and practical medicine. That's why timely diagnosis This group of diseases is undoubtedly the main component of cancer prevention. The development of cancer, as is known, is a multi-stage, sometimes quite lengthy process. Cancer is often preceded by so-called precancerous changes, and in some cases these precancerous changes are of the nature a certain disease. Shabad L.M., for example, believes that “cancer does not arise on healthy soil” and that “every cancer has its own precancer.”

Currently, the term “precancer” is used to denote changes, and also includes independent nosological entities that can lead, but do not necessarily lead to cancer. Precancerous changes differ from cancer in that they lack one or more signs, the combination of which gives the right to make a diagnosis of cancer. Thus, precancer is a process that can turn into cancer, but it is not cancer yet. Precancerous changes can transform into cancer when new qualitative changes occur.

Precancerous changes can develop in four main directions:

1. progression
2. growth without progression
3. long-term existence without significant changes
4. regression

It is clear that only the first way of development of the process: progression is the direct transition of a precancerous condition to cancer. Progression of the precancerous process can occur if the action of the carcinogenic factor continues at any stage of the development of this condition. Its course may suddenly change and malignancy may occur. On the other hand, stopping the action of a carcinogen can prevent malignancy even in cases where the precancerous disease remains to undergo very little transformation on the way to cancer.

What changes in the mucous membranes and intraorgan vascular bed can be observed in precancerous diseases?

At external inspection can be observed:

1) areas of clouding of the mucous membranes;
2) the characteristic moisture exchange is lost;
3) deep-epidermized areas are found on the surface;
4) there is a tendency to form microcracks;
5) pronounced fragility and fragility are determined blood vessels leading to bleeding.

Significant changes in the structures of the hemocirculatory bed have not yet occurred. However:

1) the trophic function of the subject is disrupted connective tissue, which is expressed in swelling, fragmentation of bundles or individual collagen fibers
2) deformation of bundles and individual fibers of collagen tissue occurs, which is accompanied by a decrease in the tone of the walls of intraorgan lymphatic vessels
3) there is a gradual loss of the supporting-trophic function of the underlying connective tissue

The most significant changes in precancerous diseases occur predominantly in the epithelium.

According to L. M. Shabad, the following pathological processes in the epithelium are distinguished:

1) uneven, diffuse, pathological, perverted, but not inflammatory hyperplasia of the epithelium with or without keratinization
2) single or multiple, merging or delimited focal non-inflammatory proliferations, regardless of the presence of anaplasia, but without infiltrating growth, accompanied by or without keratinization
3) a condition designated as “cancer in situ”, which is characterized by the following symptoms:

a) increase in cell volume;

b) polymorphism and variation in cell size;
c) change in the nuclear-cytoplasmic ratio;
d) nuclear hyperchromia;
e) grain size of the kernel;
f) the presence of large and small nuclei rich in RNA;
g) the presence of irregular mitoses;
h) “monstrous” nuclei

Changing kernels come first.

Cheilitis is a benign inflammatory disease of the lips, which affects the red border, skin and mucous membrane of the lips. This pathology is quite common. Dentists treat cheilitis. Inflammatory process on the lips can be primary (cheilitis itself) or secondary in nature, that is, it can be a symptom of other diseases.

Types of cheilitis

Primary:

exfoliative;
glandular;
meteorological;
contact allergic;
actinic.

Secondary:

hypovitaminous;
atopic;
eczematous;
plasma cell;
cheilitis due to ichthyosis.

All types of cheilitis have their own causes and characteristics clinical picture, course of the disease. Let's take a closer look at the main ones.

Exfoliative cheilitis

This is a disease that occurs as a result of various neurogenic reactions, which is characterized by damage to the red border of the lips. Heredity, psychosomatic disorders, etc. play a certain role in the occurrence of this pathology. This pathology most often affects females aged 20-40 years.

There are two forms of exfoliative cheilitis - dry and exudative. At exudative form diseases on the lips yellowish scales and crusts appear, which can reach large sizes and hang from the lip like an apron. After removing the crusts, a bright hyperemic surface is exposed, but erosions do not form. Patients are bothered by burning and pain, which can make it difficult to speak and eat. Painful sensations They intensify when the lips close, so the mouth of such patients is always slightly open.

In the dry form of cheilitis, the lesion resembles a ribbon that stretches from corner to corner of the mouth, while the skin around the lips is never affected. The scales are tightly attached in the center and may lag behind at the edges. Patients with this form of the disease are bothered by dryness and burning in the lips.

Exfoliative cheilitis is prone to long-term course, which can last for years, but is not prone to remission and self-healing.

Glandular cheilitis

This type of cheilitis develops as a result of hyperplasia, increased function salivary glands or their heterotopia in the area of the red border of the lips.

Primary glandular cheilitis is associated with congenital pathology salivary glands and is more common in males. Clinically, the disease is manifested by peeling and dryness of the red border of the lips, the appearance of dilated ducts of the salivary glands in the form of reddish dots from which saliva is released. Against this background, erosions and cracks may appear.

The secondary variant of the disease may be a consequence of inflammatory diseases of the mucous membrane or red border of the lips, which have a chronic course. Patients often experience pain when eating hot, spicy foods, or when talking.

With prolonged existence, glandular cheilitis contributes to the occurrence of precancerous diseases. This is due to constant dryness lips and their traumatization.

Contact allergic cheilitis

This disease is more common in females. Its occurrence is associated with hypersensitivity red border of the lips to chemical agents included in dentures, hygienic toothpastes, lipsticks and various cosmetics. Contact cheilitis is allergic reaction slow type. Patients complain of a feeling of dryness and burning in the lips, and the formation of cracks. After cessation of exposure to the irritating factor inflammatory phenomena subside.

Atopic cheilitis

The lips are often involved in the pathological process when. Atopic cheilitis occurs most often in childhood and adolescence. Characteristic feature is a lesion of the skin around the lips and especially in the corners of the mouth, but the process never spreads to the mucous membrane. Patients complain of redness, swelling of the lips and skin around them, itching and burning in this area. After the process resolves, an enhanced skin pattern (lichenification) remains on the lips. A characteristic feature is the pronounced itchy skin and typical rashes on the body.

Eczematous cheilitis

This type of inflammation of the red border of the lips develops when. The disease has an undulating course and is characterized by a variety of rashes. First, the lips become red and swollen, blisters and crusts appear on them, and the skin around the mouth is affected. Then acute manifestations subside, and if the cause of the disease is not eliminated, then the first wave is followed by the second and third. This is how the disease becomes chronic. The skin of the lips thickens and small cracks may appear on it.

Meteorological cheilitis

This pathology is an inflammatory disease of the lips, which develops as a result of exposure to various meteorological factors, such as wind, high and low temperatures, humidity, solar radiation, etc. Men more often suffer from meteorological cheilitis, since women use protective cosmetics(lipsticks). In this case, the lips become dry, inflamed, and acquire a bright color. Patients often lick their lips in an attempt to moisturize them, which leads to even more dryness and flaking. People with dry skin are most prone to this disease.

Actinic cheilitis

This is a disease that is caused by increased sensitivity to sunlight and can serve as a background for precancerous conditions. Men over 20 years of age are more likely to suffer from this pathology. Actinic cheilitis can occur in a dry and exudative form. The dry form is characterized by redness and dryness of the lips in spring. With the exudative form, bright red areas with blisters, erosions, and crusts appear on the lips. The pathological focus covers the entire surface of the red border of the lips and is characterized by severe swelling.

Plasma cell cheilitis

The causes of the disease are not fully understood. Chronic irritation of the lower lip, the impact of sun rays. At the same time lower lip(affected more often) has a shiny surface with erosions and pinpoint hemorrhages, sometimes crusts. Patients are concerned about lip pain and cosmetic defects.

Diagnostics

Making a diagnosis usually does not cause difficulties for a specialist. The patient's complaints, medical history, and objective data obtained by the doctor during examination and examination of the patient are taken into account. Things are more complicated with differential diagnosis and determining the type of cheilitis. If necessary, a biopsy and histological examination can be performed.

Treatment

Important stage treatment of cheilitis - proper care behind the oral cavity.

Treatment of cheilitis should be comprehensive and have individual approach. Each type has its own treatment characteristics, but there are also general measures that include:

compliance with hygienic rules for oral care;
sanitation of the oral cavity;
removal of decayed teeth and dental plaque;
elimination bad habits(licking lips, smoking, biting lips, etc.);
elimination of mechanical trauma to the lips (elimination of defects in the dentition, poor-quality fillings and orthopedic structures);
orthopedic treatment by a dentist (correction and replacement of dentures);
general and local treatment(discussed below).

Local treatment:

washing with antiseptic solutions (hydrogen peroxide, chlorhexidine, potassium permanganate) to prevent infection;
applications of proteolytic enzymes (chymotrypsin, trypsin) to soften crusts;
corticosteroid ointments (celestoderm, lorinden S, lokoid) to reduce inflammation, swelling and itching;
complex ointments with vitamins, steroids, etc.

For exfoliative cheilitis, sedatives (Sedasen, Persen), tranquilizers (Elenium), and antidepressants (amitriptyline) are prescribed to normalize the psycho-emotional state.

For glandular cheilitis after drug treatment carried out surgical removal enlarged salivary glands.

Therapy for contact cheilitis of allergic origin begins with eliminating the suspected allergen and prescribing antihistamines (suprastin, cetirizine, loratadine).

In the treatment of meteorological and actinic cheilitis, at the first stage it is important to eliminate irritating factors, then antihistamines and vitamin-mineral complexes are used.

For atopic and eczematous cheilitis, patients are recommended hypoallergenic diet, taking sedatives, antihistamines. In severe cases, oral corticosteroids may be prescribed.

Plasma cell cheilitis is treated surgically.

Physiotherapy

Supplements the main product, helps reduce symptoms and speeds up recovery.

The main methods of physiotherapy used to treat cheilitis:

(has anti-inflammatory, decongestant, desensitizing effect).
Medicinal with corticosteroids, antihistamines.
with corticosteroid ointments.
UHF therapy (has an anti-inflammatory effect, stimulates microcirculation and regenerative processes).
Microwave therapy (improves blood supply and tissue trophism, reduces inflammation and swelling, has an antiallergic effect).

Conclusion

Cheilitis, especially with a chronic, sluggish course, can often serve as a background for the development of precancerous diseases. That is why, if symptoms of the disease are detected, you should immediately seek help. medical care. A specialist will help you cope with this problem and prescribe correct treatment. With timely and adequate therapy, in most cases the prognosis for recovery is favorable.

Clinic "Moscow Doctor", a dermatovenerologist talks about cheilitis:

Eczema of lips is a manifestation general illness, which A.L. Mashkilleyson defined as inflammation of the superficial layers of the skin of a neuro-allergic nature, resulting from the action of external and internal irritants and clinically manifested mainly by redness and blisters, accompanied by itching. Histologically detected spongiosis, formation of bubbles in the spinous layer of the epidermis. In this case, allergens can be a variety of factors, for example, microbes, food substances, various medications, metals such as nickel and chromium, materials used for the manufacture of dentures, amalgam used for filling teeth, toothpaste, etc.

Clinical picture of eczematous cheilitis

Eczema of lips, like eczema in general, can occur acutely, subacutely or chronically. In this case, damage to the red border of the lips can be combined with damage to the skin of the face or be isolated.

Clinical picture acute eczema of the lips characterized by polymorphism: redness, small nodules, blisters, scales and crusts appear successively. The process is accompanied by significant swelling of the lips. It is very characteristic that even in cases where the eczematous process occurs isolated on the lips, it still at least slightly affects the skin adjacent to the red border. It should be noted that the polymorphism observed during the eczematous process is mainly of an evolutionary nature, that is, not all elements appear at once, and some rashes are formed from others.

In the chronic course of eczematous cheilitis the clinical picture is changing. The red border of the lips and areas of affected skin around the mouth thicken due to the formation of an inflammatory infiltrate. Sometimes infiltration is accompanied by a clearly defined skin pattern. On this basis, in some places small groups of small nodules, vesicles, crusts are located, scales are formed, and sometimes when the process worsens, weeping occurs. This condition is accompanied by the formation of bleeding cracks. Patients are bothered by itching.

In some patients, eczema occurs on completely unchanged lips; much less often, the onset of the eczematous process is preceded by long-existing microbial cracks. In these cases, developing lip eczema is usually considered to be microbial eczema.

For microbial eczema of the lips First, a microbial jam or microbial crack appears in the center of the lip, less often at the wings of the nose. As a result of sensitization of the skin surrounding these lesions or the red border of the lips to bacterial toxins and autotoxins, microbial eczema. In this case, the red border and surrounding skin swell, turn red, then small vesicular elements form, quickly drying into yellowish or yellowish-gray crusts. The eczematous reaction is especially pronounced near the microbial focus. The rash of vesicular elements stops quite quickly, and peeling occurs. In this state, the process can continue for a long time. But microbial eczema is rare.

Diagnosis of lip eczema facilitated by the fact that there is usually a classic eczematous skin lesion at the same time.

Differential diagnosis of eczematous cheilitis

Greatest similarity lip eczema has with allergic contact and atopic cheilitis. However, the latter usually occurs in childhood; in the clinical picture of lip damage, lichenification phenomena prevail, mainly in the corners of the mouth, where the process always spreads to the skin.

With allergic contact cheilitis, in contrast to eczema of the lips, the process has a monomorphic character, i.e. in all areas of the red border it is in the same stage, usually does not spread to the skin, and quickly resolves after the cessation of the action of the sensitizer (allergen).

The exudative form of actinic cheilitis differs from eczema of the lips in its seasonal occurrence and clear connection with insolation.

Treatment of eczematous cheilitis

Pathogenetic therapy of eczema consists in the use of desensitizing and sedative drugs, tranquilizers, histaglobulin according to the scheme, multivitamins, vascular drugs. In severe cases, corticosteroid drugs are prescribed.

Local treatment of lip eczema consists of prescribing ointments containing corticosteroids, and in case of weeping, aerosols with corticosteroids and antibacterial substances (Lorinden-S, Dermozolon, Oxycort, Flucinar, Olazol, Hypozol) 4-5 times a day for 20 minutes. Keratoplasty preparations are used - aloe juice, Kalanchoe juice, carotoline, sea buckthorn oil, “KF” paste, Unna ointment, Shostakovsky balm, Tezan emulsion, vitamins A and E in oil, Aekol, Actovegin ointment, solcoseryl dental adhesive paste. Helium-neon laser radiation, at a power density of 100 mW/cm2, No. 5-10, daily.