Band of hyperpigmentation in the perioral area: Child with lip-lick cheilitis

Band of hyperpigmentation in the perioral area: Child with lip-lick cheilitis: K Jagadish Kumar, PK Ashwini, Harish Reddy



International Journal of Health & Allied Sciences 2020 9(1):93-94



Sir,

Cheilitis presents as scaling on the lips often extending onto the perioral skin. Often seen during winter in childhood. It appears as dry scaly lips, often attributed to frequent licking to hydrate the dryness, named as lip-lick cheilitis.^[1]

A male child presented to our outpatient department with nearly asymptomatic discoloration around the lips since 6 weeks. The child gave the history that he often felt the lip and perioral area dry. He acknowledged the habit of repeated lip licking due to the above complaints. He had similar episodes during the last season of the year. There was no history of the application of any topical agents, and there was no other medical illness. On examination, a well-defined band of hyperpigmentation was noted around the lip margins. The lip and surrounding area were dry and scaly. Minimal erythema was noted on the lip [Figure 1].

Figure 1: Band of hyperpigmentation in the perioral area: Child with lip-lick cheilitis Click here to view

Lip licking is found to be the most common cause for irritant cheilitis. Some of the substances found in lipsticks, toothpastes can cause an inflammatory lip reaction called as contact cheilitis.^[2] Lip licker's dermatitis can be a manifestation of atopic dermatitis alone.^[3] Atopic dermatitis improves as the child grows older, with relatively few cases persisting into adulthood.^[1] Perioral dermatitis in children can occur due to the usage of topical steroids on that area.^[4]

The most common cause in a child would still be the irritant reaction caused by saliva. The regular use of emollients is central in the management of such cases. It helps in hydrating stratum corneum, reduces transepidermal water loss, and even reduces pruritus and inflammation, thereby reducing the requirement of topical steroids or immunomodulators. Topical steroids can be used for the shortest possible duration for the anti-inflammatory benefit.^[1]

Repeated episodes of lip lick dermatitis would present with a post-inflammatory pigmentation, as seen in our case. Habit reversal, the use of emollients to keep the area moist would help in the treatment of such cases.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 

References

1.	Abraham A, Kaimal S. Atopic dermatitis. In: Sacchidanand S, Oberai C, editors. IADVL Textbook of Dermatology. 4th ed., Vol. 1. Mumbai: Bhalani Publishers; 2015. p. 799-814.
2.	Lugović-Mihić L, Pilipović K, Crnarić I, Šitum M, Duvančić T. Differential diagnosis of cheilitis – How to classify cheilitis? Acta Clin Croat 2018;57:342-51.
3.	Silverberg NB. Typical and atypical clinical appearance of atopic dermatitis. Clin Dermatol 2017;35:354-9.
4.	Coondoo A, Phiske M, Verma S, Lahiri K. Side-effects of topical steroids: A long overdue revisit. Indian Dermatol Online J 2014;5:416-25.     [Full text]

Figures

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