Original article
Cheilitis glandularis: A clinicopathological study in 22 patients

https://doi.org/10.1016/j.jaad.2009.06.038Get rights and content

Background

Cheilitis glandularis (CG) is a condition in which thick saliva is secreted by minor labial salivary glands and adheres to a swollen lip causing discomfort to the patient. Most publications refer to single case reports or small case series.

Objective

We sought to report and to analyze clinical, pathological, and therapeutic data on 22 patients with CG seen at the department of dermatology at our university.

Method

Retrospective data about 22 patients with CG are reviewed and presented.

Results

Seventeen patients were male and 5 were female. All were fair skinned, including 6 albino individuals. Several of them presented significant signs of photodamage on the lips. Surgical treatment was performed in 10 severely affected patients and consisted of a vermilionectomy followed by minor salivary gland removal. Histopathological study revealed various degrees of chronic sialadenitis and vermilion epithelial changes. Superficially invasive and in situ squamous cell carcinoma of the vermilion was detected in 3 cases.

Limitations

Biopsy and surgery were not performed in all patients.

Conclusions

CG is strongly related to sun sensitivity and may be more severe in albino patients. The swollen, sun-exposed lip may become more susceptible to the occurrence of squamous cell carcinoma.

Section snippets

Objectives

Clinicopathological findings of 22 patients with CG from the oral diseases clinic at the dermatology department at our university are presented. Therapies used were reviewed along with histopathological aspects, with emphasis at the possible presence of SCC.

Methods

Records of 22 patients with clinical diagnosis of CG were reviewed. General data such as sex, age, and race were studied. Description of clinical lesions and associated significant dermatologic diseases were considered, as were therapies used and histopathological aspects. When surgery was performed, it consisted of a lower lip vermilionectomy followed by careful dissection and removal of minor mucous salivary glands associated. The surgical fragments were formalin fixed and the vermilion was

Results

A summary of the findings is shown in Table I. In all, 22 patients were given the diagnosis of CG, with a male preponderance (17 male, 5 female). Patient age varied from 20 to 69 years. Most patients were white and photosensitive; there were 6 albino patients (all nonwhite patients were albinos). CG was present on the lower lip of all patients and in the upper lip of 6 patients. The clinical picture varied from mild infiltration of the lip with visible ostia draining a discrete amount of

Discussion

The cause of CG is unknown. It was once considered a primary disease of minor salivary glands (heterotopia X hyperplasia),3 but Swerlick and Cooper2 compared histologic material from patients with CG with that of control subjects and found no differences in size, depth, or appearance of minor salivary glands. These authors suggest that CG represents a reaction pattern in response to chronic irritation of the lips (actinic, atopic, or factitious) and is unrelated to gland hyperplasia or

References (15)

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Funding sources: None.

Conflicts of interest: None declared.

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Copyright © 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.