Exfoliative Cheilitis Case Study

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Abstract
Exfoliative cheilitis is a rare disorder of unknown etiology causing inflammation of lips. Constant cyclical desquamation along with scaling and crusting of the lips are the salient features. These cases are usually refractory to treatment, as experienced and reported in the previous literature. We hereby report two cases of exfoliative cheiltis successfully treated with topical tacrolimus and oral olanzapine. One of our two cases was refractory to almost all forms of treatments.
Key words: exfoliative cheilitis; inflammation; olanzapine; tacrolimus Introduction
Exfoliative cheilitis is a chronic inflammatory disease affecting vermilion border of lips with no specific etiology, although initially was thought to be associated with repetitive biting, sucking, licking or picking of lips. However later it was defined as a cyclic desquamation of the lips without the evidence of factitial sources of irritation such as lip licking or biting, infection or allergens as the primary etiology of the desquamation (1). Psychological/psychiatric problems like stress, anxiety, depression, obsessive compulsive disorders are known to be strongly associated with exfoliative cheilitis in the majority of previously reported cases (2).
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Pain while speaking, eating or smiling is commonly reported. Unaesthetic appearance of lips could compromise the social life of these patients.
Majority of cases reported in the previous literature were refractory to therapy (2, 3). We hereby report two cases of exfoliative cheilitis successfully treated with combination of topical tacrolimus and oral olanzapine. One of the two cases was refractory to almost all forms of

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