Cheilitis glandularis - Oral Mucosal Lesion
The etiology of CG has not been fully elucidated. However, it is posited to be an inflammatory reaction related to chronic sun exposure, atopy, smoking, or mechanical trauma of the lips. Prolonged irritation results in hyperplasia of the minor salivary glands and dilation of secretory ducts. In addition to tobacco use and inadequate ultraviolet (UV) protection, other predisposing factors may include poor oral hygiene, an impaired immune system, and bacterial infection.
The clinical features of CG can be classified into simple, superficial suppurative, and deep suppurative types. These represent a continuum of disease stages with a progressive course.
The simple type is most common, presenting with varying degrees of lip erythema, edema, and scaling. The affected lip may develop associated nodularity. Dilated ductal orifices on the mucosal lip are seen as multiple pinpoint red papules with a central depression exuding thick mucinous discharge on palpation. The discharge can dry as a yellow crust overlying the mucosa, and individuals often report the lips feeling uncomfortably sticky and adherent.
In the superficial and deep suppurative types, there is the addition of progressive pain, spontaneous purulent discharge, erosions and ulceration, worsening macrocheilia, crust, and lip eversion. Secondary infection, leading to abscesses, fistulas, and eventual scarring, is more commonly seen in immunocompromised individuals with suppurative types.
K13.0 – Diseases of lips
26374003 – Cheilitis glandularis
Differential Diagnosis & Pitfalls