[Factitious crusting cheilitis].

The authors report 4 cases of factitious crusting cheilitis seen in young women. The lesions are crusty, yellowish or even black, forming as a mould casting the lip. The crusts are sometimes very thick just as an oyster-shell. When removed the underlying mucosa appears either normal or erosive and the crusts reappear rapidly. Emotional factors and personality disturbances are often present. Most probably the crusts are the result of a traumatic mechanism induced by chewing or sucking the lip. In the 4 reported patients the clinical aspect and the psychological status of the patients are similar, the 4 of them being not at all bothered by their cheilitis. The factitious keratotic cheilitis has to be differentiated from other cheilitis induced by Candida albicans (although Candida albicans may superinfect any cheilitis) or by an actinic phenomenon, from glandular cheilitis (of the Puente-Acevedo or of the Volkmann type) and from dermatitis localized on the lips. In some instances an exfoliative cheilitis may also to be of factitious origin. The factitious origin of such a cheilitis is always difficult to demonstrate but its possibility should be kept in mind.