dental disorders
Lip Ulcers and Inflammation
Lip ulcers and other changes
A number of infectious, neoplastic, or other disorders can cause lip ulcers, growths, and other changes: Herpes labialis (recurrent Herpes Simplex Virus (HSV) Infections ): A small cluster of fluid-filled vesicles that rupture to form an ulcer on the lip's vermilion border; commonly referred to as a cold sore or a fever blister. Treatment is most useful if started during the prodromal phase. Oral treatment includes one-day dosing of Erythema Multiforme : Multiple bullae that rupture quickly and leave crusting hemorrhagic ulcers on labial mucosa. This ulcerative mucocutaneous condition is an immune reaction usually triggered by herpes simplex virus. Erythema multiforme has a variety of appearances and often causes painful oral mucositis. Lip ulcerations are managed with topical corticosteroids or systemic corticosteroids. Primary syphilis (chancre): A painless ulcer with hard edges. Oral chancres are commonly seen on lips (upper lip more common in males; lower lip more common in females). Treatment of choice for syphilis is penicillin. Warts : Pebbly surfaced, painless growth. This benign condition can spread by autoinoculation. Treatments include use of topical agents ( Actinic keratoses : Irregular pale, red, or variably colored dry and scaly precancerous growths. This common premalignant condition is caused by chronic exposure to ultraviolet light. Treatments include reducing sun exposure (using sunscreens, wearing hats with wide brims) and laser ablation. Premalignant (dysplastic) changes or Oral Squamous Cell Carcinoma : May present variably as a hyperkeratotic nodule or plaque, ulcer with hard edges, or as erythroplakia or leukoplakia (particularly early cases that have not ulcerated). Treatment depends on clinical staging at diagnosis and includes wide surgical excision, radiation therapy, or both. Peutz-Jeghers Syndrome : Autosomal dominant condition that includes benign hyperpigmented (dark blue, brown, black) macules of skin and mucosa (especially lip and buccal mucosae), gastrointestinal hamartomatous polyps, and (unrelated to the macules and polyps) predisposition to various cancers. 