Glandular cheilitis

What is glandular cheilitis?

Glandular glandularis is a rare chronic inflammatory disorder affecting the lower lip.

Who gets glandular cheilitis?

Glandular cheilitis mainly affects older males, although it has been reported in women and young people.

What causes glandular cheilitis?

The cause of glandular cheilitis is unknown. It is associated with: 

• Sun exposure
• Trauma (eg, lip biting)
• Smoking.

What are the clinical features of glandular cheilitis? 

Cheilitis glandularis typically has the following features:

• Swelling and pouting of the lower lip
• An uneven surface of the lip
• Numerous pin-sized orifices from which saliva can be easily expressed
• Tenderness.

What are the complications of glandular cheilitis?

• Secondary bacterial infection can result in drainage of pus, ulceration and abscess formation.
• Squamous cell carcinoma may arise, particularly in the context of long term sun exposure and smoking.

How is glandular cheilitis diagnosed?

Glandular cheilitis is a clinical diagnosis. A biopsy of the affected area may be reported as nonspecific. Findings may include:

• Enlarged salivary glands and ducts
• Mixed inflammatory infiltrate 

What is the treatment of glandular cheilitis?

In most cases, treatment is not necessary and may be unsuccessful at restoring the lip to normal. In some cases, treatment for associated sun damage or infection may be necessary.

• Topical or oral antibiotics
• Topical or intralesional corticosteroid
• Excision of a nodule suspicious of squamous cell carcinoma
• Vermilionectomy (excision of the entire affected lip)

The most important advice is smoking cessation and careful protection from further sun exposure using frequent water-resistant high protection factor sunscreen lip balm.