Cheilitis glandularis: clinico-histopathological diagnostic criteria

To present a combination of clinical and histopathological criteria for diagnosing cheilitis glandularis (CG), and to evaluate the association between CG and squamous cell carcinoma (SCC).

The medical literature in English was searched from 1950 to 2010 and selected demographic data, and clinical and histopathological features of CG were retrieved and analysed.

A total of 77 cases have been published and four new cases were added to the collective data. The clinical criteria applied included the coexistence of multiple lesions and mucoid/purulent discharge, while the histopathological criteria included two or more of the following findings: sialectasia, chronic inflammation, mucous/oncocytic metaplasia and mucin in ducts. Only 47 (58.0%) cases involving patients with a mean age of 48.5 ± 20.3 years and a male-to-female ratio of 2.9:1 fulfilled the criteria. The lower lip alone was most commonly affected (70.2%). CG was associated with SCC in only three cases (3.5%) for which there was a clear aetiological factor for the malignancy.

The proposed diagnostic criteria can assist in delineating true CG from a variety of lesions with a comparable clinical/histopathological presentation. CG in association with premalignant/malignant epithelial changes of the lower lip may represent secondary, reactive changes of the salivary glands.