Ann Dermatol.  2012 Nov;24(4):455-458. 10.5021/ad.2012.24.4.455.

Three Cases of 'Morsicatio Labiorum'

• Kang HS
• Lee HE
• Ro YS
• Lee CW

• KMID: 2266042
• DOI: http://doi.org/10.5021/ad.2012.24.4.455

Abstract

Morsicatio labiorum is a form of tissue alteration caused by self-induced injury, mostly occurring on the lips, and is considered to be a rarely encountered mucocutaneous disorder. Clinically, it is a macerated grey-white patch and plaque of the mucosa caused by external stimuli (self-induced injury) such as habitual biting, chewing, or sucking of the lip. It is often confused with other dermatological disorders involving the oral mucosa, which can lead to a misdiagnosis. We herein report three cases of morsicatio labiorum; two cases were misdiagnosed as exfoliative cheilitis at the time of the first visit.

Keyword

Lip; Morsicatio labiorum; Sucking behavior

MeSH Terms

Bites and Stings
Cheilitis
Diagnostic Errors
Lip
Mastication
Mouth Mucosa
Mucous Membrane
Sucking Behavior

Figure

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  Fig. 1 (A, C) Localized yellow hyperkeratotic plaques on the upper and lower lips in patients 1 & 2. (E) A well-demarcated, white, smooth plaque on the lower lip in patient 3. (B, D, F) The lesions had completely disappeared after the patients retained from their lesion causing habits.

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  Fig. 2 (A) Histopathologic examination of the underneath mucosal surface of the plaque showed focal hyperkeratosis with basophilic debris on the surface (H&E, ×100). (B) Gram positive (purple-colored) bacterial colonies were found (Gram stain, ×100). (C) The specimen was negative for fungal infection (PAS stain, ×400). (D) The epidermis showed marked acanthosis and necrotic keratinocytes. Beneath the surface, swollen keratinocytes were seen (H&E, ×100). (E) Bacteria colonization was not observed (Gram stain, ×100). (F) The specimen was negative for fungal infection (PAS stain, ×400). (G) The epidermis showed marked acanthosis; however, bacteria colonization was not seen (H&E, ×100). (H) A gram stain was negative (Gram stain, ×100). (I) The specimen was negative for fungal infection (PAS stain, ×400).

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