Cheilitis Glandularis Apostematosa in a Female Patient – a Case Report

Abstract

Abstract Cheilitis is an inflammatory condition of the vermilion border of the lips, which is the junction between the skin and the mucosa. Cheilitis may arise as a primary disorder of the vermilion zone; the inflammation may extend from the nearby skin, or less often from the oral mucosa. Primary cheilitis lesions are either superficial or deep. Deep types include cheilitis glandularis (inflammatory changes and lip gland swelling), and granulomatous cheilitis (chronic swelling of the lip due to granulomatous inflammation mostly of unknown origin). Cheilitis glandularis is a rare condition that mostly affects the lower lip and it is characterized by nodular enlargement, reduced mobility and lip erosion. Based on clinical presentation, cheilitis glandularis may be classified into three subtypes: simplex (described as Puente and Acevedo), superficial suppurative (described by Baelz-Unna), and the most severe type - deep suppurative, also known as cheilitis glandularis apostematosa (Volkmann’s cheilitis) characterized by deep-seated inflammation forming abscesses and fistulous tracts. This is a case report of a female patient with a deep suppurative type of cheilitis affecting both lips. Treatment with systemic antibiotics (using antibiogram tests), corticosteroids and topical therapy resulted in significant improvement. Sažetak Heilitis (Cheilitis) inflamatorno je oboljenje rumene zone usana (vermiliona) koja se nalazi na prelazu kože u sluzokožu. Heilitisi koji nastaju kao samostalna oboljenja mogu biti površni ili duboki. Duboki su Cheilitis glandularis i Cheilitis granulomatosa. Cheilitis glandularis (CG) retka je bolest koja najčešće zahvata donju usnu i karakteriše je nodularno uvećanje, redukovani mobilitet i everzija usne. Kliničke varijante su CG simplex (Puente and Acevedo), CG suppurativa superficiallis (Baelz-Unna) i CG suppurativa profunda seu CG apostematosa (Von Volkmann). Mi prikazujemo bolesnicu sa dubokom supurativnom formom heilitisa na obema usnama, kod koje je sistemska primena antibiotika, prema antibiogramu, i kortikosteroida, uz lokalnu terapiju, dovela do znatnog poboljšanja.