Factitious Cheilitis: Report of Two Cases

Factitious cheilitis (FC) is a rare psychodermatologic condition characterized by self-inflicted trauma to the lips. It is frequently underdiagnosed and often mistaken for infectious or neoplastic processes. We report two cases of young adult female patients with painful verrucous lip lesions. In both cases, initial clinical suspicion included squamous cell carcinoma and pustular cheilitis. Histopathologic findings were nonspecific. Clinical history and behavior patterns revealed self-inflicted trauma. Both patients were ultimately diagnosed with FC and managed with topical treatment and referral for psychological support. These cases highlight the diagnostic challenges of FC and the importance of recognizing self-inflicted dermatoses in dermatologic practice. Failure to do so can lead to unnecessary procedures and treatments. FC should be considered in patients with chronic cheilitis and atypical lip lesions, especially in those with psychiatric comorbidities. A multidisciplinary approach is essential for proper diagnosis and management.