Dry lips with redness around in 10 y.o. boy

My 10 year old son developed slightly dry lips with redness over the top lip and under the bottom one last summer about 5 months ago. At first we thought it was simple dehidration due to traveling by airplane, but it didn't go away after drinking a lot of water and applying chapstick. Instead, it continued to get bigger.
One pediatrician diagnosed it as herpes and told us to apply famvir. After one week nothing changed.
Another doctor diagnosed it as stafilococus and gave us an antibacterial cream to apply. It got slightly better but as long as the cream was applied.
A group of other pediatricians suggested to make a blood test (which we haven't done yet) thinking that it could be due to some vitamin deficiency but gave us simple vaselin to apply. Vaselin keeps the lips soft, but has to be applied many times a day.
Every time is was suggested that this problem is due to lip licking, but I know for a fact that he doesn't lick them.
So, now 5 months later and very little improvement.
The red and dry skin is stricktly in the center as if he was drinking from a bottle and it left the circle mark.
Today we noticed a small spot of dry red skin about 1cm in diameter on his thigh. I don't know if it could be related.
I don't think that this is something contagious, because in all the 5 months no one displayed similar symptoms.
I would appreciate your opinions and suggestions!
Thanks!

[Bhupinder Kaur, MD]

Hello,

There are two possibilities that are coming in my mind.

Firstly,It can be due to vit B deficiency.Give some vitamin B complex for some days and see if your symptoms improve.
Secondly,it can be due to atopic dermatitis or eczema("Atopic" refers to a group of diseases where there is often an inherited tendency to develop other allergic conditions, such as asthma and hay fever).The dry skin patch on the lower limbs is supporting this diagnosis. Cheilitis(Inflammation of the skin on and around the lips)is often seen in atopic dermatitis.Diagnosed by bld test like RAST.Treatment is by topical steroids or oral therapy of corticosteroids in severe cases.Topical creams like tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel) are also useful.

Ask your son to avoid licking the lips ,drink plenty of water and take multivitamin supplements.Also use a humidifier to moisturize the air in your home and apply shea butter or Vaseline on his lips.You can also use a homemade ointment mixed from 1 tsp glycerine, 1 tsp lemon juice and 1 tsp castor oil. Spread on lips overnight, refrigerating the leftovers for future use. Eat foods high in calcium, magnesium and flaxseed oil. If a week of compresses and emollients don't do the trick, you can add over-the-counter 1 percent hydrocortisone ointment to his regimen.

Hope it helps.Take care and pls do keep me posted on how you are doing or if you have any additional queries.