FACTITIAL CHEILITIS

By Gary M. White, MD


Factitial cheilitis is inflammation of and injury to the lips from self-manipulation.

Differential Diagnosis

Depending upon the age, the following may be considered: atopy, actinic damage, exfoliative cheilitis, cheilitis granulomatosa or glandularis, contact dermatitis, photosensitivity reactions, and neoplasia.

Clinical

There is chronic crusting, inflammation, and at times ulceration of the lip or lips. Lesions may heal completely and then reoccur.

Treatment

The key intervention is to get the patient to develop insight into their condition, thus allowing them to stop the destructive behavior. This may be difficult. Co-morbid psychiatric conditions should be addressed. Psychotherapy and anxiolytic-antidepressant treatment may be beneficial. Selective-serotonin reuptake inhibitors with or without combined low doses of atypical antipsychotics have been recommended as self-inflicted disorders of compulsivity-impulsivity spectrum mostly benefit from this regimen.

References

J Med Case Reports. 2008; 2: 29.
Actas Dermosifiliogr. 2013;104:854-66 - Vol. 104 Num.10
Pediatr Dermatol. 1999 Jan-Feb;16(1):12-5

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