Unresolved cheilitis revisited: the importance of identifying allergic triggers in exfoliative cheilitis

Abstract

Exfoliative cheilitis (EC) is a chronic inflammation of the lips characterised by recurrent and persistent desquamation; its aetiology is varied, and its clinical presentation resembles that of other forms of cheilitis, making accurate diagnosis and appropriate treatment challenging. Failure to identify the cause, parti-cularly allergies, increases the likelihood of recurrence. This article emphasises the evaluation of triggering factors, particularly the role of allergy, in cases of EC. A 58-year-old woman presented with complaints of cracked lips, easy bleeding, and pain (VAS 6) for the past year. Extraoral examination revealed des-quamation accompanied by irregular haemorrhagic crusts on the vermilion border. Routine blood tests revealed an elevated eosinophil count, suggesting an allergic reaction. Management involved the administration of topical steroids, chlorhexidine gluconate, multivitamins, and antihistamines. It was concluded that allergies can be a trigger for persistent EC. Early identification of allergic factors is necessary for appropriate management and prevention of recurrence.