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Cheilitis Glandularis

Definition

Cheilitis glandularis is a rare chronic inflammatory disorder of the lower lip characterized by hyperplasia of the minor salivary glands.

Etiology

The etiology of cheilitis glandularis is unknown.

Main Clinical Features

•Lip enlargement

•Typically, the orifices of the secretory ducts become dilatated and appear as numerous pinhead openings from which mucus or mucopurulent secretion may be expressed on pressure

•Crusting, erosions, and microabscesses may occur

•Characteristically, the lesions are limited to the lower lip

Diagnosis

The clinical diagnosis should be confirmed by a biopsy and histopathologic examination.

Differential Diagnosis

•Cheilitis granulomatosa

•Melkersson-Rosenthal syndrome

•Crohn disease

•Orofacial granulomatosis

•Sarcoidosis

•Tuberculosis

•Lymphedema

•Lymphangioma

Treatment

Basic Guidelines

•There is no causative treatment.

•The treatment is palliative.

Suggested Therapies

•Topical ointment or intralesional injection of corticosteroids may offer temporary and limited improvement.

•Systemic oral corticosteroids, e.g., prednisone 20-30 mg/day for 2-3 weeks, followed by tapering and stopping the drug in a month’s time has also limited value as the disease recurs.

•Systemic antibiotics, e.g., minocycline 100-200 mg/day for 2-4 weeks, may temporarily improve the condition, particularly if an infection is present.

•Plastic surgery (vermilionectomy) for reconstruction of an enlarged lip is necessary for advanced severe cases.

References

Cohen DM, Green JG, Diekmann SL. Concurrent anomalies: Cheilitis glandularis and double lip: report of a case. Oral Surg Oral Med Oral Pathol 1988;66:397–399.

Leao JC, Feneira AM, Martins S, et al. Cheilitis glandularis: An unusual presentation in a patient with HIV infection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:142–144.

Stoopler ET, Carrasco L, Stanton DC, et al. Cheilitis glandularis: An unusual histopathologic presentation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:12–17.

Swcrlick RA, Cooper PH. Cheilitis glandularis: A reevaluation. J Am Acad Dermatol 1984;10:466–472.

Venma S, Cheilitis glandularis: A rare entity. Br J Dermatol 2003;148:362.