Talk:Cheilitis

Article categorization

This article was initially categorized based on scheme outlined at WP:DERM:CAT. kilbad (talk) 17:14, 23 June 2009 (UTC)

Proposed merge

Hello to all! I am proposing a merge from the following articles into this article:

• Plasma cell cheilitis  Not done
• Allergic contact cheilitis  Done
• Cheilitis glandularis  Done
• Cheilitis exfoliativa  Done

This is for the following reasons:

• The main article would benefit significantly from having all this information in one place.
• These articles are very short in length (1-2 sentences) and have not been edited significantly in 3-4 years.
• This knowledge shouldn't be obscured from readers of this article by virtue of being isolated in an obscure article of 1-2 lines.
• These topics may receive more attention by being mentioned in the main article.
• The articles, if needs be, could be re-expanded at a later date.

Kind Regards, LT90001 (talk) 02:09, 25 August 2013 (UTC)

Generally agree with this merge (presumably merging all these to cheilitis?). However, plasma cell cheilitis is also termed plasma cell gingivits, and can affect other parts of the mouth like the tongue too. Not sure in the case of plasma cell cheilitis it would be good merge into cheilitis, because it could equally belong on gingivitis or glossitis. Not to make a point, but I just moved plasma cell cheilitis to plasma cell gingivitis, because I found it to be the more notable name in searches. I'll see what I can do about merging the other stubs into the main cheilitis page. Lesion (talk) 20:13, 25 August 2013 (UTC)

• Plasma cell cheilitis is a v rare presentation of a condition which more usually affects the gums, hence I renamed that page "plasma cell gingivitis", although I have added a small section to this page to link to it, I don't think merge is a good idea. Lesion (talk) 13:57, 26 August 2013 (UTC)
• What is the difference between chapped lips and exfoliative cheilitis? Maybe we should merge that page here too? Lesion (talk) 13:57, 26 August 2013 (UTC)
• Struggled to find sources for "drug induced ulcer of the lip". Only pubmed hit was from the 60s, which is concerning. Lesion (talk) 14:30, 26 August 2013 (UTC)
• The article's looking really good! I'll do a copyedit and have a look for some sources tomorrow. LT90001 (talk) 14:40, 26 August 2013 (UTC)
• Thanks, Lesion (talk) 14:44, 26 August 2013 (UTC)

Proposed merge with Chapped lips

Suspect "chapped lips" is the layterm for the medical jargon "exfoliative cheilitis". Per WP:MEDMOS#Naming conventions, we should be using the most commonly used term in recent scientific publications. Lesion (talk) 14:35, 26 August 2013 (UTC)

• Amazingly, after a few searches, I have not found any clear answer to this. No-one seems to want to define chapped lips with a medical term, possibly suggesting that it is a medical term in its own right. This however ignores the fact that any extensive discussion of lip disorders in medical publications rarely uses the term "chapped lips". I found only 2 sources which defined chapped lips as cheilitis, [1] [2] but I found a few others which included phrases like "chapped lips or cheilitis" or gave both terms separately in a list. Currently, to say chapped lips=cheilitis would be to cherry pick some sources and to ignore others. Also not sure if exfoliative cheilitis can be called chapped lips, because in the former, there is overproduction of keratin and shedding of crusts on the lips. Chapped lips has no real definition I think, but probably does not refer to any overproduction of keratin, but rather to acute irritation from drying, cold, wind, etc. Since I have no source which states exfoliative cheilitis=chapped lips, this also could be OR to suggest. Not sure what is best, might be better to leave them separate, see what others say. Lesion (talk) 22:04, 26 August 2013 (UTC)

I'm not a pathologist, but it seems chapped lips refers to a moderate degree of traumatic or environmental erosion of the mucosa, rather than an inflammatory process. LT90001 (talk) 22:47, 26 August 2013 (UTC) (In consideration of what's been written below I withdraw this comment and support a merge.) LT90001 (talk) 22:11, 27 August 2013 (UTC)

Erosion does have a specific definition, i.e. a superficial, partial thickness loss of epithelium which does not extend into the connective tissue. It is generally held to be a mild form of ulceration, (see also Oral_ulceration#Definition). I think the main process in chapped lips is drying, leading to desquamation and cracking. Therefore, I'm not sure it is accurate to say there is mucosal erosion, unless the cracks penetrate the epithelial continuity. Lesion (talk) 11:36, 27 August 2013 (UTC)

• I'm no expert but it seems there isn't enough (any?) overlap between dry lips vs. inflammation of the lips to justify a merge. Biosthmors (talk) 12:52, 27 August 2013 (UTC)

But dessication causes inflammation... I was looking at some of the "chapped lips" pictures that people have uploaded to commons, and you can't deny there is inflammation present. As always, one is left wondering if these people have received a diagnosis froma healthcare professional before uploading their images... or do they constitute "self diagnoses". Logically, if we take our cheilitis definition (which believe it or not I had to struggle to find a reliable source for) as "inflammation of the lips", and considering we already discuss both primary and secondary inflammatory processes affecting the lips on this page, then shouldn't we at least mention what chapped lips here too? I would really like a source which makes things clear, but I found none, hence the request for comments. Lesion (talk) 13:07, 27 August 2013 (UTC)

It might also be worth mentioning that a regular google search often yields results which confuse exfoliative cheilitis with chapped lips, or treat them as part of the same spectrum, but these are definately not MEDRS, they are link farms, health forums, etc etc. Lesion (talk) 13:11, 27 August 2013 (UTC)

• Per this ref "Cheilitis simplex is known to patients as "chapped lips"." also known as common cheilitis. [3] This ref seems to say it is the same as exfoliative cheilitis aswell [4] This ref also supports [5]
• This ref is the best I have found and makes things clear. [6]. Support merge to cheilitis and split off when section on "cheilitis simplex" becomes too large. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:00, 27 August 2013 (UTC)

Thanks for that, not heard that term before. Do seem to get better results from google book search. Here is another textbook which says "Cheilitis simplex (Chapped lips)" [7] whilst here is another which states "Cheilitis simplex, synonym: cheilitis". [8] Can't escape the feeling that the clinical descriptions of cheilitis simplex are identical to exfoliative cheilitis too. Total lack of standardization in terminology strikes again? Lesion (talk) 16:45, 27 August 2013 (UTC)

• Per LT and James' agreement, and the 2 sources dug out saying cheilitis simplex is the most common form of cheilitis, another source saying that cheilitis simplex = cheilitis, and also because I note that chapped lips page is mostly unreferenced and in a poor state currently, I think the argument to merge is stronger. I am still unsure, but happy to carry out the merge and see how it looks. If a consensus develops to move it back, so be it. Lesion (talk) 22:30, 27 August 2013 (UTC)

Order of sections

The types (as reflected in the sections) need some logical order; either by how common they are, or alpha.--Epeefleche (talk) 15:04, 20 March 2014 (UTC)

They are vaguely in order of most common to least common currently, or at least a grouped all the more common ones first, but in no particular order with regards each other, if that makes sense. Chapped lips should definitely be first, as is current imo. Lesion (talk) 15:23, 20 March 2014 (UTC)

I noted that the second category is "uncommon." But a number of categories below is one which states "Chronic eczematous reactions account for the majority of chronic cheilitis cases". The two suggested to me that they may not be in order of which is most common. Thoughts?--Epeefleche (talk) 15:26, 20 March 2014 (UTC)

Feel free to adjust according to what the sources are saying. In general, it is probably more common to have an acute inflammation of the lips compared to chronic. As I said the current arrangement is only vaguely in order of common to rare. Lesion (talk) 16:55, 20 March 2014 (UTC)

What we really need is a source which explicitly states the order for us, but I have yet to find one. Lesion (talk) 17:06, 20 March 2014 (UTC)

Understood. I'm happy to defer to you any order that follows any logic. I just could not divine any logic in the current order, and given the above (with the second category being deemed "uncommon") this order seemed haphazard. Best.--Epeefleche (talk) 20:48, 20 March 2014 (UTC)

My opinion (i.e. not a source) would be that all these are common, and apart from putting chapped lips first I would not be confident to give any particular order to them:

• Chapped lips
• Angular cheilitis
• Actinic cheilitis
• Eczematous cheilitis
• Infectious cheilitis (all infectious causes would include most cases of angular cheilitis... but the term "infectious cheilitis" is not commonly used, perhaps that is why it is later in the list?) Lesion (talk) 21:01, 20 March 2014 (UTC)

Plasma cell gingivitis

Using talk page to avoid edit conflicts. The image of plasma cell gingivitis is not relevant here imo... this article is about lips, not gums... we don't have any pic of plasma cell cheilitis, presumably because it is so rare. Lesion 18:43, 18 April 2014 (UTC)

Good catch. Agreed.--Epeefleche (talk) 01:13, 19 April 2014 (UTC)

BTW -- I think the second image is a bit duplicative of a later image -- do you think we could do without it? Tx.--Epeefleche (talk) 06:49, 19 April 2014 (UTC)

Do you mean the second image is the same as the third? If so, then maybe the second should go as the third is a close up and better quality... Lesion 08:17, 19 April 2014 (UTC)

Yes -- seeking to reflect the same thing (chapped lips). I agree. Tx. Wish we had some more images on commons of some of the other categories. --Epeefleche (talk) 08:23, 19 April 2014 (UTC)

If there is an image that grabs you (the first one?), feel free to move it into the infobox. It has a slot for an image. Tx. --Epeefleche (talk) 08:28, 19 April 2014 (UTC)

I have no preference for any of the imgs. Cheilitis is a general term and they all show it. If you want a lead image please feel free. Regards, Lesion 20:29, 19 April 2014 (UTC)

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