A 35-year-old female patient exhibited an enduring one-year history of cheilitis accompanied by eczema-like lesions on her hands, manifesting over the course of approximately two months. Notably, the patient and her family had no documented familial predisposition to atopic diseases. Clinical examination revealed the presence of oozing erosions, overlaid with honey-yellow crust, situated at the commissures of her mouth. Further examination disclosed epithelial desquamation in the form of flaking skin, erythema, atrophic changes, and multiple fissures within the vermilion border (Figure 1). Additionally, minor epidermal desquamation with slight hyperkeratosis was observed on the palm skin.
The patient’s prior therapeutic history encompassed a regimen of medications, including cetirizine, doxycycline and hydroxyzine. Local treatment involved the application of Combiderm (comprising Clotrimazole 1%, beclometasone dipropionate 0.025%, and gentamicin sulfate 0.1%). Despite these interventions, while her hand condition exhibited discernible improvement, the cheilitis remained recalcitrant. In pursuit of an alternative opinion and therapeutic approach, the patient sought consultation at our facility.
Treatment and Clinical Course
The patient was prescribed a meticulously tailored herbal medicinal formula designed to address her distinctive clinical presentation. Additionally, she was advised to use a lip barrier herbal yufu cream and adhere to sun protection measures. In concurrence with this therapeutic approach, the use of topical corticosteroids (Combiderm) was promptly discontinued. Over a span of three months, the cutaneous lesions exhibited gradual regression, with complete resolution of the vermilion border lesions achieved by the fourteenth month (Figure 1).
This case report underscores the intriguing association between chronic cheilitis and atopic dermatitis (eczema), a manifestation often characterized by eczematous changes. Notably, the persistent dryness of the skin, frequently observed in the course of atopic dermatitis, can incite a maladaptive habit wherein patients recurrently lick their lips. Paradoxically, this habit can exacerbate the inflammatory state in the perioral region due to the irritative effects exerted by the digestive enzymes present within saliva. Consequently, our report underscores the significance of recommending not only customised herba formula for routine skin care but also specialized barrier herbal balms for the lips in the comprehensive management of eczema patients.
In situations where the disease information had already been made publicly available (as evidenced by prior articles), genuine names of individuals have been utilized. Conversely, in instances where there was no pre-existing public disclosure or at the explicit request of patients for privacy, pseudonyms have been employed. Furthermore, identities have been deliberately obscured, and certain contextual details and diagnoses have been modified to hinder any attempts at identification. It is essential to emphasize that the patients and encounters described in this work are authentic, and their consent for publication was duly obtained. As responsible authors, we earnestly implore all our readers to honor the privacy and confidentiality of these individuals. Additionally, certain scenarios, assessments, and clinical interventions have been altered to safeguard the anonymity of both patients and healthcare providers.