Archive for August, 2012

Treatment of Exfoliative Cheilitis

Treatment of Exfoliative Cheilitis Determination of cause Supportive care Topical or intralesional corticosteroids, including lip ointments/ pomade (hypoallergenic) Topical tacrolimus ointment Prognosis Chronic Psychologic support for factitial cheilitis

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Differential Diagnosis of Exfoliative Cheilitis

Differential Diagnosis of Exfoliative Cheilitis Atopic cheilitis Actinic cheilitis Contact cheilitis

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Clinical features of Exfoliative Cheilitis

Clinical features of Exfoliative Cheilitis Usually involves lower lip (in both genders); can involve both lips Tender or asymptomatic crusts and impacted scale of vermilion Minimal inflammation Diagnosis Clinical appearance Nonspecific microscopy results

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Eitiology / Causes of Exfoliative Cheilitis

Eitiology / Causes of Exfoliative Cheilitis Causes may be atopic, contact, factitious, infectious, systemic, or medication induced.

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Treatment of Candidiasis

Treatment of Candidiasis Topical or systemic antifungal agents For immunocompromised patients: routine topical agents after control of infection is achieved, usually with systemic azole agents See “Therapeutics” section Correction of predisposing factor, if possible Some cases of chronic candidiasis may require prolonged therapy (weeks to months). Prognosis Excellent in the immunocompetent host

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Differential Diagnosis of Candidiasis

Differential Diagnosis of Candidiasis Diagnosis Microscopic evaluation of lesion smears • Potassium hydroxide preparation to demonstrate hyphae • Periodic acid–Schiff (PAS) stain • Culture on proper medium (Sabouraud’s, corn meal, or potato agar) • Biopsy with PAS, Gomori’s methenamine silver (GMS), or other fungal stain of microscopic sections Differential Diagnosis • Allergic or irritant contact […]

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Clinical features of Candidiasis

Clinical features of Candidiasis Acute (thrush) • Pseudomembranous • Painful white plaques representing fungal colonies on inflamed mucosa • Erythematous (acute atrophic): painful red patches caused by acute Candida overgrowth and subsequent stripping of those colonies from mucosa Chronic • Atrophic (erythematous): painful red patches; organism difficult to identify by culture, smear, and biopsy • […]

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Eitiology / Causes of Candidiasis

Eitiology / Causes of Candidiasis Infection with a fungal organism of the Candida species, usually Candida albicans Associated with predisposing factors: most commonly, immunosuppression, diabetes mellitus, antibiotic use, or xerostomia (due to lack of protective effects of saliva)

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Treatment of Actinic (Solar) Cheilitis

Treatment of Actinic (Solar) Cheilitis Prevention of further damage with sunscreens blocking longwave ultraviolet A (UVA) and short-wave ultraviolet B (UVB) light Biopsy of clinically suspicious areas CO2 laser vermilionectomy Topical 5-fluorouracil or vermilionectomy for severe disease Excision or resection-reconstruction if malignant transformation has occurred Prognosis  Lifelong follow-up  Up to 10% develop into squamous cell […]

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Differential Diagnosis of Actinic (Solar) Cheilitis

Differential Diagnosis of Actinic (Solar) Cheilitis Diagnosis Thermal/chemical burn ruled out by history Chronic ultraviolet light exposure Biopsy findings Differential Diagnosis Exfoliative cheilitis  Squamous cell carcinoma

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