eMedicine Specialties > Dermatology > Diseases of the Oral Mucosa

Cheilitis Glandularis: Follow-up

Author: Ellen Eisenberg, DMD, Professor, Section Chair and Director, Oral and Maxillofacial Pathology, Oral Pathology Biopsy Service, Department of Oral Health and Diagnostic Sciences; Associate Professor, Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, University of Connecticut Health Center
Contributor Information and Disclosures

Updated: Dec 31, 2008

Follow-up

Further Outpatient Care

  • Monitor patients with documented actinic cheilitis with clinical observation once or twice a year for an indefinite period. This is because, in some cases, the condition has the potential for the development of lip carcinoma. Also, some patients with cheilitis glandularis may be at risk for the development of suppurative episodes if trauma to the lip surface is continuous. This can result in chronic ulceration or erosion, leading to portals of entry for bacterial invasion and inflammatory sequelae.
  • Clinical evidence of disease progression mandates biopsy and an appropriate treatment plan (topical chemotherapy with 5-fluorouracil or vermilionectomy, or in cases of squamous cell carcinoma, lip wedge resection).
  • Decisions concerning the advisability and timing of surgical cheiloplasty or vermilionectomy can be challenging in patients who exhibit clinical evidence of persistent habitual or deliberate factitial injury.
    • Undertaking surgery is ill advised if the source of irritation or trauma is perpetuated.
    • Patients who are highly symptomatic and/or functionally compromised by lip enlargement and its complications should be offered the option of surgical debulking, regardless of the cause.
    • Whether or not the surgical approach is ultimately successful depends on factors unique to the patient.

Deterrence/Prevention

  • Where relevant, patients who habitually lick their lips should be advised to avoid this behavior.
  • Sun-protective measures (eg, wearing a hat with a visor, lip balm with sun-blocking agents, avoidance of direct and protracted sun exposure) must also be instituted.

Prognosis

  • Cheilitis glandularis has been associated with a heightened risk for the development of squamous cell carcinoma.
  • In many cases, dysplastic (premalignant) surface epithelial change is evident, and frank carcinomas have been reported in 18-35% of cases.

Patient Education

  • Reinforce instruction in measures for sun protection.
 


More on Cheilitis Glandularis

Overview: Cheilitis Glandularis
Differential Diagnoses & Workup: Cheilitis Glandularis
Treatment & Medication: Cheilitis Glandularis
Follow-up: Cheilitis Glandularis
Multimedia: Cheilitis Glandularis
References
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References

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Further Reading

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Keywords

cheilitis glandularis, CG, suppurative sialadenitis, suppurative stomatitis glandularis, actinic cheilitis, squamous cell carcinoma, myxadenitis labialis, cheilitis apostematosa, Baelz disease, Baelz's disease

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Contributor Information and Disclosures

Author

Ellen Eisenberg, DMD, Professor, Section Chair and Director, Oral and Maxillofacial Pathology, Oral Pathology Biopsy Service, Department of Oral Health and Diagnostic Sciences; Associate Professor, Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, University of Connecticut Health Center
Ellen Eisenberg, DMD is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology
Disclosure: Nothing to disclose.

Medical Editor

Mark W Cobb, MD, Consulting Staff, WNC Dermatological Associates
Mark W Cobb, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and American Society of Dermatopathology
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Drore Eisen, MD, DDS, Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati
Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, and American Dental Association
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System
William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology
Disclosure: elsevier Royalty Other; american college of physicians Honoraria Other

 
 
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