Cheilitis: a comprehensive review and a new clinical classification proposal. Part 1: Isolated cheilitis

Area of Science:

• Dermatology
• Oral Medicine

Background:

• Cheilitis is lip inflammation, potentially isolated or linked to systemic/dermatological conditions.
• Clinical assessment is challenging due to diverse causes and lack of standardized classification.
• Existing classifications lack univocal recommendations.

Purpose of the Study:

• To introduce a practical etiological classification for cheilitis.
• To provide a systematic framework for evaluating and managing lip inflammation.
• To categorize cheilitis based on its origin and associated conditions.

Main Methods:

• Literature review to identify various cheilitis types and their associations.
• Development of a four-category etiological classification system.
• Categorization based on isolated lip involvement, association with dermatological conditions, systemic diseases, or drug induction.

Main Results:

• Proposed classification includes: 1) Isolated cheilitis (simplex, contact, exfoliative, granulomatous, glandular, plasma cell, actinic, infectious).
• 2) Cheilitis associated with dermatological conditions (atopic dermatitis, lichen planus, autoimmune bullous diseases, discoid lupus erythematosus, psoriasis).
• 3) Cheilitis associated with systemic diseases (SLE, orofacial granulomatosis, sarcoidosis, Crohn's, Melkersson-Rosenthal, nutritional deficiencies).
• 4) Drug-induced cheilitis (oral retinoids, erythema multiforme, SJS, TEN, DRESS syndrome).

Conclusions:

• The proposed etiological classification offers a practical tool for clinicians.
• A systematic approach aids in the evaluation and management of cheilitis.
• Understanding the etiology is crucial for effective patient care.