A long post on several different issues.
A. Granulomatous type of cheilitis.
Apparently Cheilitis Granulomatous shows up as lumpy lips, so probably you can tell if your lips have become lumpy or not.
I've got some pretty thin lips myself, and I am sure that there are no lumps in my lips. Those of you with more prominent, fuller lips might ask yourself if they were always like that, or if they only got thicker and fuller with the advent of the surface exfoliation/irritation symptoms of cheilitis.
"Granulomatous cheilitis refers to an uncommon condition in which there is lumpy swelling of the lips."
See the accompanying photos on that website, and look for other photos on the internet showing this disorder.
Dermatitis is a name for skin inflammation. It is a broad term.
Having a diagnosis of dermatitis does not say what is causing the problem. It is a descriptive term.
Having a doctor tell you that you have dermatitis does not mean that you are not going to suffer ill-effects from the inflammation in the future, or that you should stop trying to find the cause of the skin inflammation.
The causes of skin inflammation are sometimes tricky to find. Many times, doctors are at a loss to figure it out.
(See my nail polish story elsewhere on this forum for how a tiny substance on my toenails gave me a year of facial rash hell when I was 28, and no doctor that I saw figured it out. They finally diagnosed me with " Seborrheic Dermatitis
" and told me I'd have it the rest of my life and just to use steroids on it - and they were wrong, it was contact dermatitis and it went away the day that I stopped using toenail polish, even though I never got the polish nor my toes anywhere near my head.)
Obviously, some people have long-term skin inflammation and only can control it, never get rid of it. Sometimes skin inflammation runs in families.
Dermatitis of the lips is also called cheilitis. Cheilitis is the name for skin inflammation of the lip area. Another name for this same thing is cheilosis.
Stomatosis is the name of inflammation of the mouth, although sometimes that term is used to describe inflammation of the mouth AND the lips.
B1. "Dermatitis simply means skin inflammation, but it embraces a range of ailments. In most cases the early stages are characterized by red, itchy skin, although acute attacks may result in crusty scales or blisters that ooze fluid. Since many things can irritate the skin, a doctor will try to narrow the diagnosis to a specific category of dermatitis, even though treatment is similar for most types of skin irritation and inflammation."
B2. Excellent article on dermatitis - this excerpt here is just the introduction
"Dermatitis (eczema) is inflammation of the upper layers of the skin, causing itching, blisters, redness, swelling, and often oozing, scabbing, and scaling.
Known causes include contact with a particular substance, certain drugs, varicose veins, constant scratching, and fungal infection.
Typical symptoms include a red itchy rash, blisters, pimples, open sores, oozing, crusting, and scaling.
The diagnosis is typically based on symptoms and confirmed by results of patch tests or skin samples or the presence of suspected drugs, irritants, or infection.
Avoiding known irritants and allergens reduces the risk of dermatitis.
Treatment depends on the cause and the specific symptoms.
Dermatitis is a broad term covering many different disorders that all result in a red, itchy rash. The term eczema is sometimes used for dermatitis. Some types of dermatitis affect only specific parts of the body, whereas others can occur anywhere. Some types of dermatitis have a known cause, whereas others do not. However, dermatitis is always the skin's way of reacting to severe dryness, scratching, an irritating substance, or an allergen. Typically, that substance comes in direct contact with the skin, but sometimes the substance is swallowed. In all cases, continuous scratching and rubbing may eventually lead to thickening and hardening of the skin.
Dermatitis may be a brief reaction to a substance. In such cases it may produce symptoms, such as itching and redness, for just a few hours or for only a day or two. Chronic dermatitis persists over a period of time. The hands and feet are particularly vulnerable to chronic dermatitis, because the hands are in frequent contact with many foreign substances and the feet are in the warm, moist conditions created by socks and shoes that favor fungal growth.
Chronic dermatitis may represent a contact, fungal, or other dermatitis that has been inadequately diagnosed or treated, or it may be one of several chronic skin disorders of unknown origin. Because chronic dermatitis produces cracks and blisters in the skin, any type of chronic dermatitis may lead to bacterial infection."
C. Cancer risk in dermatitis.
Slight rise in cancer risk seen with atopic dermatitis
Arch Dermatol 2005;141:1123-1127.
"...the team reports in the September issue of the Archives of Dermatology, atopic dermatitis patients were 13% more likely to develop cancer. They were 3.5 times more likely to develop esophageal cancer, and roughly twice as likely to develop brain or lung cancer or lymphoma. A similarly increased risk of pancreatic cancer was seen, but it was of borderline statistical significance. Men faced a 50% increased risk for non-melanoma skin cancer during the first 10 years of follow-up, which did not reach statistical significance."
D. Cancer risk in cheilitis.
D1. To me, it is logical to assume that any place where skin layers are rapidly (and I mean daily, in my case) dying, exfoliating, and growing at a greater than normal pace is a place on the body where the skin cells are inherently out of control, or are being pushed out of control by something that is irritating them.
I am no physical scientist, but I seem to recall learning that cells have a certain number of times that they can divide and replicate, before dying - and, as their dna splits and replicates time after time, the occurrance of mutations is higher with each replication, and some cell mutations can cause cancer. This is why older people have more cancer than younger people - if we live long enough, most of us will get some sort of cancer.
D2. There is a specific type of cheilitis which leads 6-10% of the time to lip cancer. It is called actinic cheilitis or solar cheilitis.
(see slide number 3 for this excerpt and a photo of the actinic cheilitis)
"Actinic Cheilitis (Farmer's Lip)
Related to actinic keratosis, actinic cheilitis is a precancerous condition that usually appears on the lower lips.
Scaly patches or persistent dryness and cracking of the lips may be present.
Less common symptoms include swelling of the lip, loss of the sharp border between the lip and skin, and prominent lip lines.
Actinic cheilitis may evolve into invasive squamous cell carcinoma if not treated."
by Juliet Cohen
"Actinic cheilitis is a diffuse degenerative difference of the lower mouth as an outcome of sunlight harm. It occurs primarily in men and does not submit until after 50 years of age, but the reason is frequently utmost sunlight vulnerability during the adolescent years and inexperienced grownup living. Almost all cases happen on the lower mouth vermilion, likely because of the more immediate sunshine vulnerability of that place. The lower mouth is almost frequently affected. Individuals with actinic cheilitis frequently complain of relentless dryness and cracking of the lips. They will often display new effects of sun-damaged rind, such as precancerous lesions on the rind called actinic keratoses and comprehensive wrinkling. In actinic cheilitis, there is thickening whitish discoloration of the mouth at the edge of the mouth and rind. There is too a departure of the normally steep edge between the red of the mouth and the natural rind, known as the vermillion edge.
Actinic cheilitis is characterized by a diffuse scaling on the lower lip that cracks and dries. Sometimes the lip has a whitish discoloration on the thickened lip. Life-time occupational sun exposure increases the risk. The lip becomes puffy and blotchy red and pale pink, with occasional white plaques (leukoplakia) and chronic ulcers. A certain type of skin cancer develops in 6–10% of cases of actinic cheilitis. Anyone who develops actinic cheilitis has extensive sun-damaged skin. This makes one more susceptible to other forms of skin cancer, including melanoma. Melanoma is considered the most lethal form of skin cancer because it can rapidly spread to the lymph system and internal organs. The lesion is usually painless, persistent, more common in older males, more common in individuals with a light complexion with a history of chronic sun exposure.
Actinic cheilitis needs to be differentiated from many new lip conditions, and the dermatologist must be attune to its theory whenever assessing scaly lips. Because of its potentiality to produce into squamous cubicle carcinoma, handling should be instituted as shortly as potential. Ultraviolet light from the sunlight and tanning beds causes rind cancer and wrinkling. If you seek to seem like you’ve been in the sunlight, regard using a sunless self-tanning merchandise. When using a self-tanning merchandise, you should remain to take sunscreen. In little utmost cases, doctor may urge devastation of the destroyed cells with a carbon dioxide laser. Alternative treatments include the consumption of electrical flow to kill the precancerous cells and a facial sanding technique. Topical therapy with a chemotherapeutic broker or a topical immunomodulator may be prescribed."
(by the way, my lips have some times resembled the lips in a couple of these photos over the last few months)
"What is solar cheilitis?
Solar cheilitis is a term used to describe benign or pre-malignant changes on the lip due to chronic sun exposure. It is also often called actinic cheilitis, and sometimes, actinic cheilitis with histological atypia.
The word “cheilitis” means an inflammatory condition of the lips. Solar cheilitis affects the vermilion, i.e. the red part of the lip.
What are the symptoms of solar cheilitis?
Solar cheilitis most commonly results in the following features:
•Thinned skin of the lips
Less common features of solar cheilitis include:
•Swelling of the lip
•Redness and soreness
•Ulceration and crusting
•Loss of demarcation between the vermilion border of the lip and its adjacent skin
•Prominent folds and lip lines
•White thickened patches (leukokeratosis)
•Discoloured skin with pale or yellow areas
Well-defined scaly areas on the lips in solar cheilitis may be solar keratoses or Bowen disease (squamous cell carcinoma in situ).
Invasive squamous cell carcinoma should be suspected if a persistent ulcer or lump develops."
Cheilitis in Humans
By Louie Doverspike, eHow Contributing Writer
"Cheilitis is any medical condition involving an inflammation of the lips. A variety of maladies can induce cheilitis in humans. It can be a side effect or an indicator of a deeper problem.
Malnutrition can cause cheilitis. The most common form is lip inflammation caused by a lack of vitamin B12.
One of the most common causes of repetitious cheilitis is a chronic condition such as anemia or Plummer-Vinson syndrome. A drop in red blood cells can cause discomfort in the entire mouth.
Bacterial and fungal infections of the mouth can often produce cheilitis as a side effect. Thrush and other yeast infections of the tongue are especially likely to cause cheilitis.
Certain medications can cause lip inflammation. Most notable is the isotretinoin class of medication, the most widely used of which is Accutane.
If you are unsure of the cause of your cheilitis, seek help. **Cheilitis can often be a side effect of mouth and skin cancers.**"
If a competent doctor recommends a lip biopsy, he or she probably has a good reason for doing so (unless he/she is unscrupulous and just wants the income). He/she probably has looked at every other option, and cannot solve your cheilitis. If that seems reasonable to you, and if everything else has been explored, and if the doctor suspects cancer, then it seems like it probably would be a good idea to have a biopsy.
However, I don't recommend going to a new doctor and right off the bat, before trying a lot of other treatments first, insisting on a biopsy, because lip biopsies can be painful, usually seem not to turn up much information (at least for the EC sufferers that are on this specific forum), and can leave a scar.
F. The members of this forum are only a small and unusual subset of those who have cheilitis.
We tend to take the groups of people we are familiar with to be a representative sample of the world. However, this forum is in NO way a representative sample of the people in the world who have cheilitis. Therefore, one ought not to deduce much from what members of this forum have or haven't written about their condition, or have or haven't been diagnosed with/treated for by doctors.
This forum is a good place for sharing information, a good place for discussion, but this forum shouldn't be anybody's main source of knowledge or comfort about their lip irritation/inflammation/condition.
If you honestly have what you think is cheilitis, and intelligent attempts at self-treatment over the course of several months have not worked, if it's at all possible for you, you should see a doctor about it, and preferably get opinions from more than one doctor, if you can.
Long-term cheilitis that doesn't go away with common-sense measures can be caused by something relatively harmless (which sometimes can turn into something bigger down the road), or it can be caused by something pretty big and scary right from the start, and it's not something to take lightly.