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Red rash at cornor of mouth and dry burning lips

What is a 58 year old, professional/married woman, (otherwise healthy) doing up at 4:00 am searching the internet for a solution to a medical problem that she has been to a doctor three time over the past month?  Desperate...I woke up with my lips burning.

On April 24th, I volunteered at a local art event which was held in a factory.  My station was close to furnaces and it was hot and the next day my lips were chapped.  For a week, I used a medical chapstick and instead of getting better, a red rash developed at the cornor of my mouth and the inside of my mouth felt like it was full of cotton or "morning" mouth; blisters appeared on the lower lip.  I went to my internist who diagnosed the problem as "Bacterial" and prescribed Amoxicellan (sp?) He said to call if after five days their was no relief.  I was traveling on a business trip and called after six days to advise no relief (however, I completed the 10 day dosage).  He then prescribed an anti-viral (Azmsol sp?, I returned the prescription to him, so I don't have the exact name of the presription) I took that medication for six days (twice a day), and no relief and in fact two days after starting that medication I became sick with burning sore throat and took three days off from work this past week.  During this time, I had difficulty speaking and was constantly coughing up flem.  I went back to work on Thursday.  Today, Saturday those symphtoms (cough, sore thoat and coughing up flem) appear to be gone. I returned to the internist this past Thursday, he took me off the anti-viral because it appears that it has not helped and he prescribed Ketoconazole an anti-fungal. (He also ordered blood tests for which I do not have results as yet) I started using this topical cream Thursday, it burned the first time.  However, I have applied it as directed twice a day and no sign of improvement.  This problem has been going on for over a month, with no signs of improvement.  Perhaps in your experience as a Dermatologist, you can suggest other diagnosis and possible treatment.  I recognize that advise without seeing a patient would be difficult, but I don't know what else I can do. I have never used the internet this way before and hoping that this site is not a hoax.  My current condition is:  some dry mouth, not as bad as in the beginning, red rash at the cornor of mouth extending out 1/2" on to the skin, dry cracked lower lip, which bleeds and burns from time to time.  Only relief is pure vaseline jelly.  Awaiting your response.  Best regards,
1 Responses
242489 tn?1210500813
MEDICAL PROFESSIONAL
My best guess is that you had a viral or perhaps bacterial infection which caused sore throat and phlegm, but that this infection is long gone, through treatment or just through time.  What you have left is inflammation of the lip as an aftermath.  To treat it, I suggest you apply 1% hydrocortisone (over-the-counter), preferably in a vaseline ointment base 3-4 times a day.  Just in case there is a yeast component at the corner of the mouth, I would add clotrimazole cream 1% (also OTC) 1-2 times a day.  Vaseline can be helpful too.  (All creams can be applied sequentially, without pause.)  I suggest further that you arrange to see a dermatologist, so that the condition can be evaluated in person in case the treatment I outline hasn't taken care of it.

Best.

Dr. Rockoff
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