Lips

Question 1

Recurrent Herpes Labialis

Answer 1

herpes simplex HSV “cold sore”
Prodrome (itching, burning tingling) 12-36hrs -> eruption of clustered fluid filled vesicles along vermilion border -> rupture, ulceration, & crusting

Question 2

Carcinoma of lips

Answer 2

Often SCC
Lesion: painless, elevated, sharply demarcated, slow-growing, fails to heal, can bleed, found on mucocutaneous junction of lips
Dx: Biopsy

Question 3

Mucocele

Answer 3

Called Ranula if under tongue
Soft cyst, mucin-filled cavity with mucous glands lining the epithelium
Etiology: minor injury to ductal system by trauma
SSX: thick, mucus-type saliva produced by damaged gland creates clear or bluish bubble, movable, cystic, may rupture,
Can persist, rarely goes away on it’s own, DDS can remove

Question 4

Cheilitis

Answer 4

Erythema & scaling of lips “chapped lips”
Etiology: use of retinoids, wind-burn, allergies
May become secondarily infected by candida

Question 5

Angular Cheilitis aka perleche

Answer 5

Etiology: ill-fitting dentures, sicca (dry mouth), poor oral hygiene, nutritional deficiencies, (esp. vit B2 riboflavin, B12 cyanocobalamin) & iron deficiency anemia

SSX: Deep cracks at labial commissure, form shallow ulcers, often bilateral, can become infected by Candida albicans, staph aureus

Lab: KOH prep to assess for Candida infx