LIPS

Question 1

Recurrent Herpes Labialis (herpes simplex virus)

Answer 1

aka “cold sore” or “fever blister”
PRODROME: itching, burning, tingling that lasts approximately 12 to 36 hours, followed by eruption of clustered vesicles along the vermilion border. Subsequent rupture, ulceration and crusting
TRIGGERS: UV light, trauma, fatigue, STRESS, menstruation.
CONCERNS: re auto- inoculation to eye and skin. infectious

Question 2

Carcinoma of the lips

Answer 2

OFTEN: squamous cell cancer (SCC)
SIGNS & SX: painless (initially) lesions, sharply demarcated, elevated and hard, may be verrucous (cauliflower-like) or plaque like
LOCATION: mucocutaneous junction of lips
RED FLAGS: slow growing, fails to heal, bleeds. high risk of metastasis
DX: biopsy!

Question 3

mucocele

Answer 3

SIGNS & SX: thick, mucus-type saliva produced by the damaged gland creates a clear or bluish bubble, movable, cystic, may rupture. Bleeding may occur, making cysts red or purple. rarely goes away on its own (can be surgically removed)
LOCATION: minor labial or sublingual salivary gland
ETIOLOGY: minor injury by trauma

Question 4

cheilitis

Answer 4

aka “chapped lips”
SIGNS & SX: erythema and scaling of the lips
ETIOLOGY: use of retinoids, wind-burn, allergies, chronic lip licking (saliva causing irritant dermatitis)
CONCERNS: may become secondarily infected

Question 5

angular cheilitis

Answer 5

aka “perleche” “cheilosis” “angular stomatitis”
SIGNS & SX: deep cracks at labial commisure, if severe can split or bleed, form shallow ulcers. Often bilateral
ETIOLOGY: elderly: ill-fitting dentures, loss of teeth changing bite, sicca (dry mouth); poor oral hygiene, nutritional deficiencies (esp vit B and Fe deficiency anemia), allergic rxn
CONCERNS: may become infected by Candida albicans, Staph aureus.
LAB: KOH prep (+ Candida)