Hypersensitivity of the lower lip; rash inside of lower lip

[HermosaJim]

For the past year or so my lips have become extremely sensitive.  They are not chapped, but have a constant burning sensation.  Sometimes it hurts to separate my lips or smile big.  Also, a bumpy rash has developed behind my lower lip (inside my mouth).  There are never any large white blisters, but it feels like there may be pus oozing out of the rash occasionally.  Could this be oral herpes or something similar?

[Bhupinder Kaur, MD]

Hello,
Since your girlfriend had oral lesions when you first had them , so definitely cold sores need to be ruled out. Although they don’t appear inside the mouth but they have to be ruled out for sure. The only way of ruling it out is by getting yourself tested for oral herpes. Laboratory tests include: culture of the virus, direct fluorescent antibody (DFA) studies to detect virus, skin biopsy, and polymerase chain reaction (PCR) to test for presence of viral DNA. I sincerely advise you to consult a dermatologist and get it ruled out.
Hope it helps. Take care and please do keep me posted on how you are doing or if you have any additional doubts. Kind regards.

[HermosaJim]

Thank you for your quick response.  I'd rule out vitamin B deficiency since I have a balanced diet and take a daily multivitamin.  I'm not sure about atopic dermatitis.  After researching that online, it appears that it affects external skin.  Can it cause a rash inside my mouth (i.e. behing my lower lip)?

I have been beginning to think that this rash may be related to kissing my ex-girlfriend.  About 6 months before my lips started bothering me, she had developed a crusty scab in the middle of her lower lip and one above her upper lip.  We made out once before I noticed it, but didn't kiss her again until it was fully healed.  Her scabs did not reappear any other time while we dated (~4 months).  Is it possible that my inner lip rash developed from kissing her and didn't show any symptoms for 6 months?  I have no symptoms outside of my mouth, just the hypersensitivity of my lips and the rash behind my lower lip inside my mouth.

Thanks

[Bhupinder Kaur, MD]

Hello,
Firstly, It can be due to vit B deficiency. Take some vitamin B complex for some days and see if your symptoms improve.
Secondly, it can be due to atopic dermatitis. 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. If the symptoms are severe then it would be best to consult a dermatologist.

I hope it helps. Take care and please do keep me posted on how you are doing or if you have any additional doubts. Kind regards.