Atopic cheilitis is an inflammatory pathology of the red border of the lips of a chronic nature, resulting from an allergic reaction of the body to a variety of irritants. The disease manifests itself in the form of itching, burning, swelling, soreness, dryness, peeling of the border of the lips and the skin of the perioral region. Diagnosis is based on the data of clinical manifestations, anamnesis, histological examination, skin tests. Treatment includes vitamins, corticosteroids, antihistamines, topical hormonal ointments, and Bucca rays. The patient is recommended a diet, smoking cessation and alcohol cessation.
Atopic cheilitis is a lip lesion caused by high sensitivity to allergens. This disease belongs to the category of symptomatic cheilitis and is considered one of the signs of neurodermatitis (atopic dermatitis), although no other pathology may appear for a long time.symptoms other than lip involvement. Experts in the field of modern dentistry believe that atopic cheilitis is largely due to a genetic predisposition, but environmental factors also play an important role in its occurrence. The disease most often occurs in adolescents and children aged 5 to 17 years and often resolves on its own with the completion of puberty. It should also be noted that in recent decades, there has been an "aging" of the age group of patients - this type of cheilitis is increasingly occurring in people over 40.
Reasons
In most cases, the development of atopic cheilitis is associated with the patient's hereditary predisposition to atopic allergies, as well as disorders of the central and autonomic nervous systems. The pathological process is triggered as a result of any disturbances in the functioning of the body: chronic diseases, a general decrease in immunity, malnutrition, lack of vitamins and minerals, high mental and physical stress, frequent stress.
There are a huge number of different irritants that are the direct cause of allergic reactions. Among the most common allergens are plant pollen, drugs, household dust, food products and much more. In addition, relapses of the pathological process are caused by diseases of the lungs and digestive tract, pathologies of the endocrine system, diseases of the ENT organs, psychological stress, intestinal dysbacteriosis, bad habits andother factors.
Symptoms
With atopic cheilitis on the lips, the patient has specific symptoms that are characterized by damage to the border of the lips and areas around it, and this is most intense in the corners of the mouth. The mucous membrane of the oral cavity is never involved during the pathological process. The disease begins with a slight swelling of the lips, dryness and itching. After that, a clearly defined spot of bright pink color is formed on the affected surface of the border, which is called "erythema".
Subsequently, the acute symptoms of atopic cheilitis may subside, there is tissue lichenization in the affected area. Peeling and infiltration of the red border develop, small grooves and cracks form. A characteristic symptom of atopic allergy is the presence of similar skin lesions in other parts of the body (folds of the elbows, face, popliteal areas).
This disease of the red border of the lips is characterized by seasonal manifestations, but exacerbations occur, as a rule, in autumn and winter, and in the summer the symptoms of the disease disappear. It is noted that in many young patients, the symptoms of the pathology often disappear on their own with the completion of the puberty stage, although later relapses are still possible.
Diagnostic measures
Atopic cheilitis is diagnosed by a dentist, based on the clinical picture, anamnesis data. If necessary, can be carried outsome additional studies: morphological analysis of the affected tissues and skin tests to reliably determine the causes of the development of an allergic reaction. For a complete diagnostic picture, other highly specialized specialists can also be involved - an allergist, an otolaryngologist, a gastroenterologist and a dermatologist. Histological signs of this pathology are uniform acanthosis, parakeratosis, the presence in the dermis of perivascular infiltrates of histiocytes, lymphocytes and eosinophils.
Atopic cheilitis is differentiated from identical types of cheilitis in terms of symptoms: exfoliative, actinic and allergic, as well as from candidal and streptococcal seizures. Actinic differs from atopic by a clearly traceable connection between the pathological process and insolation, exacerbation of symptoms in the spring-summer period and the absence of damage to the corners of the mouth.
Exfoliative cheilitis is not characterized by an undulating course, the presence of tissue infiltration and pink erythema in the affected areas. In addition, with this form, the skin and corners of the lips are not affected by the pathological process. Allergic cheilitis should be ruled out by the absence of dependence of the symptoms of the disease on the contact of the lips with the allergen. Quite similar in manifestations are candidal and streptococcal seizures, which affect the corners of the mouth, but with these diseases there is no tissue lichenization specific to the atopic form of cheilitis. In addition, the disease must be differentiated from lupus erythematosus of the lips by examining the affected areas underWood's lamp.
Treatment procedures
General therapy involves the elimination of irritating factors and non-specific desensitizing treatment: for this purpose, antihistamine drugs for cheilitis are used ("Loratadin", "Chloropyramine", "Hifenadine", "Mebhydrolin"), corticosteroid drugs ("Dexamethasone", "Prednisolone"), sodium thiosulfate (intravenously), "Histaglobulin" (subcutaneously). If necessary, the patient may be prescribed tranquilizers ("Diazepam", "Oxazepam", etc.).
Vitamin therapy is also carried out - vitamins such as B1, B6, B12 are very important, S, PP. Local therapy involves the use of ointments based on corticosteroids - hydrocortisone ointment, "Prednisolone". According to the instructions for use, the agent is applied in a layer to areas of the skin that have undergone inflammation up to three times a day. It is possible to use a bandage on limited inflamed areas. The duration of therapy is 6 days, if necessary, it is increased to 10 days. The maximum application period is 14 days.
In addition, applications on the affected areas of the lips of keratoplastic agents, oil vitamins A and E, the use of adhesive dental paste are recommended. With a weak effectiveness of conservative treatment, a good result is the use of Bucca's boundary rays.
Diet
An important role in the treatment of atopic cheilitisdiet plays. From the diet, it is necessary to eliminate foods that can provoke the development of allergic reactions (chocolate, citrus fruits, strawberries, caviar, spicy, s alty, smoked dishes, etc.) and significantly reduce carbohydrate intake. It is also important to completely stop drinking alcohol and smoking.
In children
Atopic cheilitis in a child often appears due to the fact that he is exposed to strong wind, ultraviolet radiation or high temperature for a long time.
Sometimes this disease has a glandular form, which is characterized by inflammation of the minor salivary glands of the lips. Such a disease appears in most cases due to the abnormal development of the glands of the congenital type. This form of pathology most often occurs due to a genetic predisposition.
Eczematous form
The disease can also have an eczematous form, which is accompanied by an inflammatory process on the skin. To eliminate the symptoms, steroid ointments are prescribed.
The main drug used to eliminate the symptoms of the chronic form of the disease is Prednisolone ointment. The instructions for use confirm that it is prescribed not only for adult patients, but also for children.
Forecast
When properly treated, the prognosis is usually quite good. In children with the end of puberty, the manifestations of the pathological process can disappear almost completely on their own, but this does not excludelikelihood of relapse in adulthood.
Prevention
To prevent the occurrence of atopic cheilitis, it is necessary to constantly monitor the state of he alth, increase immunity, conduct timely treatment of chronic diseases, eat fully and properly, avoid stress, excessive mental and physical exertion. If there is a predisposition to allergies, it is necessary to exclude foods that cause sensitization of the body from the diet, avoid contact with allergens (drugs, plant pollen, dust, animals, etc.), reduce the amount of carbohydrate foods, quit smoking and stop drinking alcohol.
