Lip rash?

I seem to have a rash on both sides of my upper lip. It doesn't extend over the borders, just a rough patch of tiny bumps that covers the entire lip -- and feels worse towards the outer corners, smoother in the center. It feels a little chapped, but doesn't itch. Any ideas?

A few notes about me -- I've been diagnosed with rosacea in the past, however, I have not had any rosacea for about a year -- and do not have any other rashy areas now. I've never had a cold sore. I have had a mango allergy on my lip before, but have not come in contact with mango skin or sap in about a year.

I once felt like I had a reaction to a new kind of toothpaste which was similar, causing rashiness/swelling on my lips, but I was on vacation and could not see a doctor. Sometime in the past weekend, I tried a new toothpaste. Could that be the culprit? Does a toothpaste rash present like this?

More importantly, if I go to a dermie, will they be able to pinpoint anything? Should I go to an allergist?

Thanks for your help!

[Alan Rockoff, MD]

I suggest a skin doctor (dermie?)  Toothpaste is often blamed for this kind of thing, most often inaccurately.  Try 1% hydrocortisone cream a coupole of times a day while waiting to see the doctor.  Your response (or lack of response) may help clarify the situation.  I think you may have cheilitis, or eczema of the lip.  This usually has no specific cause, but is easy to treat.

I can't think of any connection with rosacea.

Best.

Dr. Rockoff