The FP diagnosed contact dermatitis (secondary to compulsive lip licking) and angular cheilitis (perlèche) in this patient.
Lip licking can cause a contact dermatitis to the saliva, along with perlèche. Perlèche is derived from the French word, “lecher,” meaning to lick. Patients with atopic dermatitis are predisposed to contact dermatitis, so this should be explored as an underlying factor in cases like this.
This patient was told that she had to stop licking her lips in order to get well. She was also told to apply clotrimazole cream and 1% hydrocortisone ointment twice daily (both available over the counter). Within 2 weeks she was fully healed. The FP recommended that she apply plain petrolatum to her lips should they feel dry.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: French L, Usatine R. Angular cheilitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:203-205.
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