Grey, dry scaling of outer part of LOWER LIP

[ceecil1959]

I have a problem with my lower lip since the last year and a half. Initially, I felt that it was drying and irritant with skin very slightly peeling. I went to the dermatalogist and diagnosed it as some form of Actinic Cheilitis and prescribed some treatment. It was more due to the sun he told me - Actinic Keratosis. So, he first sprayed it with LIQUID NITROGEN and although it seems to work, it really did not. He did this about 3 times.

I was then asked to use a gel called SOLARAZE which really did not work either.  Then he examined me for the progress and by now after about 6-8 months, I found the lip more pronounced with grey scaling in 3 small areas. This is more on the outer of the lower lip and not the inner part. It is dry, grey and scaly about a cm to 1.5 cm by 1/2 a cm. I was then asked to use EPICERAM and that did nothing either except that it pays the pharma companies for their bs if you know the price of these creams.

I was then  treated for Planus Lichen and I used TOPICORTE for inflammation and irritation of the lip. I used it for 6 weeks and found no progress or improvement. A biopsy was done and came back negative. However, I was told that the diagnosis was mucosal hyperplasia - chronic irritation of the lip. But what has that got to do with the grey scaling?. I was asked to used NEOSALUS which has done nothing.

I am looking to see if any doctor can give me some advice as to how to proceed as it is a year and a half now and nothing has improved.

[ceecil1959]

I decided to use Flourouracil cream which seems to make it better. You need to use it carefully about twice a week or every 5 days or so. It could make the lips black if you overdo it and sometimes the lip may bleed. But if you use it carefully, it is fine. Better than all the other creams I have used so far.

I see a definite improvement in some areas of my lip. There is the main area that the drying and light scaling has not yet disappeared but that is because I have not been using the cream as I should. I am waiting for a new tube from India as it is expensive here and without a prescription, it is not possible.

I also continue to use a plain corticosteroid - Hydrocortisone.

[brainteasertugger]

Hi, I have been reading and I'm very intrigued by yout case because I have the similar problem I was diagnosed with actinic cheilitis two months ago and dermatologist also gave me neosalas which done nothing. Then I was given corticosteroid (1% hydrocortisone) like yourself but it has done nothing, please let me know how your treatment is going.

Thanks

[ceecil1959]

Thank you Doctor Kaur for your response and advice. I am using a corticosteroid (1% hydrocortisone) and also applying ABREVA which seems to at least remove the irritation at times. I am not going to the doctor in a hurry as all that was done in the last few visits was inspect and prescribe a new cream. Once the biopsy was negative and the diagnosis was mucosal hyperplasia, I decided to go about it slowly. It is not sore, it does not pain but it surely not normal and is scaly at places on the lower lip.

[Bhupinder Kaur, MD]

Hello,
Biopsy is one of the most confirmatory test for lichen planus. Topical corticosetroids and analgesics are the usual treatment. But if they are ineffective and the condition is severe, the systemic corticosteroids may be used. Pimecrolimus is also beneficial for which I suggest you to get it evaluated from a doctor.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.