1 Department of Dermatology, Medical School, University of São Paulo, Brazil.
2 Department of Psychiatry, Medical School, University of São Paulo, Brazil.
J Cutan Med Surg. 2019 May/Jun;23(3):277-281. doi: 10.1177/1203475418825112. Epub 2019 Jan 17.
The terms exfoliative cheilitis, factitial cheilitis, and morsicatio labiorum are used to describe self-inflicted lesions of the lip.
Here we report and analyze clinical, pathological, and therapeutic data on 13 patients with a form of factitial cheilitis that we believe should be considered a separate entity.
Eight patients were male and 5 patients were female. All patients reported pain and presented with crusts consisting of dried saliva and topical medications adherent to the surface of the lips. These patients expressed great concern with their condition, and reported several previous, ineffective treatments. Simple reassurance only was not effective; saline compresses alleviated symptoms for a few patients. Most patients were lost to follow-up. Biopsies were not performed on all patients.
This particular type of cheilitis artefacta has been previously described, but some features described herein are new and allow a specific approach: patient's behavior, the "protrusion sign," and possible improvement with antidepressants. For these cases, we propose the term ointment pseudo-cheilitis because it comprises the nature of the attached material and the lack of true inflammation. Further psychiatric characterization is a logical next step in further characterizing this difficult-to-treat condition.
剥脱性唇炎、人为性唇炎和习惯性咬唇等术语用于描述唇部的自伤性病变。
本研究报告并分析了 13 例我们认为应视为一种独立实体的人为性唇炎患者的临床、病理和治疗资料。
8 例为男性，5 例为女性。所有患者均诉唇部疼痛，并出现由干燥唾液和附着于唇部表面的局部用药组成的结痂。这些患者对自己的病情非常关注，并报告了多次先前无效的治疗。单纯的安慰并不有效；生理盐水湿敷可缓解少数患者的症状。大多数患者失访。并非所有患者都进行了活检。
这种特殊类型的人工性唇炎以前已有描述，但本文描述的一些特征是新的，可采用特定的方法：患者的行为、“突出征”以及可能通过抗抑郁药改善。对于这些病例，我们提出软膏性假性唇炎这一术语，因为它包含了附着物质的性质和缺乏真正炎症这两个方面。对这些病例进行进一步的精神疾病特征分析是进一步阐明这种难以治疗的疾病的合理下一步。
