Patch Testing of Patients with Eczematous Cheilitis

Jang, Seok Hwan; Yun, Sook Jung; Lee, Jee Bum; Kim, Seong Jin; Lee, Seung Chul; Won, Young Ho

Abstract

BACKGROUND
Eczematous cheilitis can be caused by endogenous or exogenous factors. Exogenous causes include contact of the lips with lipsticks, toothpastes, and topical medications.
OBJECTIVE
We sought to investigate the causative allergens in 56 eczematous cheilitis patients.
METHODS
We identified patients who had visited the Department of Dermatology at Chonnam National University Hospital in Gwangju, Korea between January 2004 and February 2013. Clinical characteristics including age, gender, medical history, disease duration, and patch test results were evaluated.
RESULTS
Among 56 patients with eczematous cheilitis, 41 (73.2%) tested positive to one or more antigens in the patch test. The patch test results were clinically relevant in 25 patients. Consequently, allergic contact cheilitis was diagnosed most commonly (25 patients, 44.6%), followed by irritant contact cheilitis (13 patients, 23.2%), and endogenous cheilitis (5 patients, 8.9%). The causative factors were undetermined in 13 patients (23.2%).
CONCLUSION
The common causes of allergic contact cheilitis were exposure to lipstick casings, lip cosmetics such as lipsticks and lip balms, and products like toothpaste. Nickel sulfate was the most common antigen found in the patch test, followed by fragrance mix and balsam of Peru. Patch testing should be performed in patients with chronic eczematous cheilitis to identify possible causes of allergic contact dermatitis.