Cheilitis Glandularis: A Case Report of an Unusual Occurrence

Cheilitis glandularis (CG) is a rare chronic inflammatory condition of unknown etiology affecting the minor salivary glands of the lips. It presents as redness and dilatation of the ostia of minor salivary glands on the vermilion border, with variable degrees of macrocheilia and eversion of the lower lip. A 36-year-old male patient had a chief complaint of burning sensation, with persistent swelling of the lower lip for two years and gradual appearance of ulcerations, crustations and intermittent oozing of liquid. Being a shepherd by occupation, he was constantly exposed to sunlight, suggesting the role of actinic radiation. The blood count parameters were normal with slightly raised ESR. No antibodies were detected in the antibody profile. On biopsy, histological evaluation showed prominent lympho-plasmacytic (Ig G4+++ plasma cells) infiltrate, atrophy of salivary acini, ductal ectasia, and sclerosis of collagen. The patient was treated with systemic, perilesional steroid injections and a topical immunosuppressant. Cheilitis glandularis may mimic many other clinical conditions, hence thorough investigations are required to establish correct diagnosis and suitable care. The case highlights the actinic radiation-mediated inflammatory process as etiopathogenesis in such lesions.