Cheilitis glandularis: A clinicopathological study in 22 patients

doi:10.1016/j.jaad.2009.06.038

Journal of the American Academy of Dermatology

Volume 62, Issue 2, February 2010, Pages 233-238

https://doi.org/10.1016/j.jaad.2009.06.038 Get rights and content

Background

Cheilitis glandularis (CG) is a condition in which thick saliva is secreted by minor labial salivary glands and adheres to a swollen lip causing discomfort to the patient. Most publications refer to single case reports or small case series.

Objective

We sought to report and to analyze clinical, pathological, and therapeutic data on 22 patients with CG seen at the department of dermatology at our university.

Method

Retrospective data about 22 patients with CG are reviewed and presented.

Results

Seventeen patients were male and 5 were female. All were fair skinned, including 6 albino individuals. Several of them presented significant signs of photodamage on the lips. Surgical treatment was performed in 10 severely affected patients and consisted of a vermilionectomy followed by minor salivary gland removal. Histopathological study revealed various degrees of chronic sialadenitis and vermilion epithelial changes. Superficially invasive and in situ squamous cell carcinoma of the vermilion was detected in 3 cases.

Limitations

Biopsy and surgery were not performed in all patients.

Conclusions

CG is strongly related to sun sensitivity and may be more severe in albino patients. The swollen, sun-exposed lip may become more susceptible to the occurrence of squamous cell carcinoma.

Section snippets

Objectives

Clinicopathological findings of 22 patients with CG from the oral diseases clinic at the dermatology department at our university are presented. Therapies used were reviewed along with histopathological aspects, with emphasis at the possible presence of SCC.

Methods

Records of 22 patients with clinical diagnosis of CG were reviewed. General data such as sex, age, and race were studied. Description of clinical lesions and associated significant dermatologic diseases were considered, as were therapies used and histopathological aspects. When surgery was performed, it consisted of a lower lip vermilionectomy followed by careful dissection and removal of minor mucous salivary glands associated. The surgical fragments were formalin fixed and the vermilion was

Results

A summary of the findings is shown in Table I. In all, 22 patients were given the diagnosis of CG, with a male preponderance (17 male, 5 female). Patient age varied from 20 to 69 years. Most patients were white and photosensitive; there were 6 albino patients (all nonwhite patients were albinos). CG was present on the lower lip of all patients and in the upper lip of 6 patients. The clinical picture varied from mild infiltration of the lip with visible ostia draining a discrete amount of

Discussion

The cause of CG is unknown. It was once considered a primary disease of minor salivary glands (heterotopia X hyperplasia),³ but Swerlick and Cooper² compared histologic material from patients with CG with that of control subjects and found no differences in size, depth, or appearance of minor salivary glands. These authors suggest that CG represents a reaction pattern in response to chronic irritation of the lips (actinic, atopic, or factitious) and is unrelated to gland hyperplasia or

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There are more references available in the full text version of this article.

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Citation Excerpt :
When there is associated fungal infection, antifungal agents should be used [2,16–20,23]. Cheilitis glandularis (CG) is a rare inflammatory condition of uncertain origin, which affects the lower salivary glands of the lip of predominantly male and fair-skinned individuals [3,24,25]. Some authors consider that this disease has endogenous origin in altered small salivary glands located in the labial mucosa.
To present a brief review of the literature on the different types of cheilitis, focusing on the clinical, histopathological and treatment characteristics.
Electronic databases were searched for studies assessing published researches and case reports on all types of cheilitis.
Cheilitis is the term that refers to the inflammatory state of the lips, which may involve the perioral region, lip vermilion and/or labial mucosa, with lip vermilion being the most affected area. There are different types of cheilitis and amongst the most commonly reported in the literature there are: actinic, desquamative/factitious, glandular, contact/eczematous, angular, granulomatous, plasma cell, associated or secondary to skin or systemic diseases, drug-induced or drug reaction cheilitis.
The diagnosis of inflammatory conditions of the lips requires a complete clinical examination and, when necessary, complementary tests in order to achieve a correct diagnosis and satisfactory treatment for the different conditions. Dental surgeons and physicians must know the importance of the correct diagnosis to indicate the best therapy for each type of cheilitis, aiming patients’ well-being and better prognosis.
Masqueraders of angioedema after a dental procedure
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Precursor Lesions for Squamous Carcinoma in the Upper Aerodigestive Tract
2020, Gnepp's Diagnostic Surgical Pathology of the Head and Neck, Third Edition
The chapter provides historical context and biological understanding of precancerous changes, and describes disorders that predispose to squamous carcinoma. It discusses grading systems for use at different head and neck sites, with no single grading system being applicable to all, and those developed for cervix, colon, and other sites being inappropriate. Oral lesions are more diverse than laryngeal lesions, with a different approach required for dysplasia grading at the two sites because of the restricted opportunities for intervention in the larynx. The current World Health Organization classifications are included, together with newly described conditions such as human papillomavirus–associated dysplasia in the mouth. Terminology is updated and the normal microscopic anatomy of the sites reviewed.
A Diagnostic Approach to Recurrent Orofacial Swelling: A Retrospective Study of 104 Patients
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To identify patients evaluated in an outpatient setting at our institution with a presentation of recurrent orofacial swelling and to review the spectrum of causes to outline a diagnostic approach.
A retrospective study of 104 patients with more than 1 episode of orofacial swelling lasting for more than 5 days identified through a keyword search of the electronic health record from January 2, 2000, through July 5, 2011.
Patients were categorized according to final cause of orofacial swelling: idiopathic orofacial granulomatosis, solid facial edema due to rosacea and acne vulgaris, Crohn disease, contact dermatitis, sarcoidosis, exfoliative cheilitis, lichen planus, actinic cheilitis, cheilitis glandularis, lymphedema, miscellaneous, and multifactorial. Granulomatous inflammation was noted on biopsy in 40 of 85 patients (47%). Oral involvement was associated with Crohn disease (P<.001), and facial and periorbital swelling was associated with solid facial edema in the setting of rosacea and acne vulgaris (P<.001).
The broad range of diagnoses responsible for recurrent orofacial swelling underscores the diagnostic challenge and importance of a thorough multidisciplinary evaluation to identify underlying causes.

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Original articleCheilitis glandularis: A clinicopathological study in 22 patients

Background

Objective

Method

Results

Limitations

Conclusions

Section snippets

Objectives

Methods

Results

Discussion

J Am Acad Dermatol

Oral Surg Oral Med Oral Pathol

J Am Dent Assoc

Oral Surg Oral Med Oral Pathol

Oral Surg Oral Med Oral Pathol

Einige fälle von cheilitis glandularis apostematosa (myxadenitis labialis)

Virchows Arch

Cheilitis glandularis–heterotopic salivary glands and squamous cell carcinoma

Br J Dermatol

Original article
Cheilitis glandularis: A clinicopathological study in 22 patients