Abstract
Lip lesions are a common presentation to the pediatrician's office. These lesions are often benign in children, without significant functional morbidity. However, owing to the prominent placement of lips and their role in communication, lip lesions can be alarming to patients as well as to their parents. For these reasons the pediatrician has an important role in recognizing, diagnosing, and treating the various types of labial dermatoses that commonly present to a pediatric practice. Four of the most common lip lesions a pediatrician will see are herpes simplex/recurrent herpes labialis, impetigo, mucoceles, and hemangiomas. This paper reviews the current literature on the diagnosis, treatment, and management of these 4 lesions.
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References
1.
1.
Sadler TW
. Head and neck . In: Langmans Medical Embryology , 7th ed.
Baltimore : Williams Wilkins ; 1995 :312 -346 .
2.
2.
Brown ZA
,
Benedetti J
,
Ashley R
, et al. Neonatal herpes simplex virus infection in relation to asymptomatic maternal infection at the time of labor . N Engl J Med . 1991 ;324 :1247 -1252 .
3.
3.
Balciunas BA
,
Overholser CD
. Diagnosis and treatment of common oral lesions . Am Fam Physician . 1987 ;35 :206 -220 .
4.
4.
Glick M
,
Siegel MA
. Viral and fungal infections of the oral cavity in immunocompetent patients . Infect Dis Clin North Am . 1999 ;13 :817 -831 .
5.
5.
Corey L
,
Spear PG
. Infections with herpes simplex viruses: I . NEngl JMed . 1986 ;314 :686 -691 .
6.
6.
Corey L
,
Spear PG
. Infections with herpes simplex viruses: II . N Engl J Med . 1986 ;314 :749 -757 .
7.
7.
Marsh P
,
Martin MV
. Oral microbiology . 4th ed.
Oxford : Wright ; 1999 :147 -152 .
8.
8.
Scott DA
,
Coulter WA
,
Lamey P-J.
Oral shedding of herpes simplex virus type 1: a review . J Oral Pathol Med . 1997 ;26 :441 -447 .
9.
9.
Whitley RJ
,
Kimberlin DW
,
Roizman B.
Herpes simplex viruses . Clin Infect Dis . 1998 ;26 :541 -553 .
10.
10.
Kameyama T
,
Sujako C
,
Yamamoto S.
Shedding of herpes simplex virus type 1 into saliva .j Oral Pathol . 1988 ;17 :478 -481 .
11.
11.
Emmert DH
. Treatment of common cutaneous herpes simplex virus infections . Am Fam Physician . 2000 ;61 :1697 -1708 .
12.
12.
Whitley RJ
. Herpes simplex virus in children . Curr Treat Options Neurol . 2002 ;4 :231 -237 .
13.
13.
Spruance SL
,
Rowe NH
,
Raborn GW
, et al. Perioral famciclovir in the treatment of experimental ultraviolet radiation-induced herpes simplex labialis: a double-blind, dose-ranging, placebo-controlled, multicenter trial . JInfect Dis . 1999 ;179 :303 -310 .
14.
14.
Tyring S.
Single-day, oral valacyclovir in the treatment and prevention of cold sore lesions . Poster presentation. Am Acad Dermatol Summer Meeting . New York City , August 1-3, 2002 .
15.
15.
Vander Straten M
,
Carrasco D
,
Lee P.
et al. A review of antiviral therapy for herpes labialis . Arch Dermatol . 2001 ; 137 :1232 -1235 .
16.
16.
Spruance SL
,
Rea TL
,
Thoming C.
Penciclovir cream for the treatment of herpes simplex labialis: a randomized, multicenter, double-blind, placebocontrolled trial . JAMA . 1997 ;277 :1374 -1379 .
17.
17.
Spruance SL
. Prophylactic chemotherapy with acyclovir for recurrent herpes simplex labialis . J Med V7irol . 1993 ;PMID8245889 :27 -32 .
18.
18.
Raborn GW
,
Mc Gaw WT
,
Grace M
, et al. Oral acyclovir and herpes labialis: a randomized, double-blind, placebocontrolled study . JAm Denzt Assoc . 1987 ;115 :38 -42 .
19.
19.
Shriner DL
,
Schwartz RA
,
Janniger CK
. Impetigo . Cutis . 1995 ;56 :30 -32 .
20.
20.
Rhody C.
Bacterial infections of the skin . Prim Care . 2000 ;27 :459 -473 .
21.
21.
Rystedt L
,
Stranngard IL
,
Strannegard O.
Infections as contributing factors to atopic dermatitis . Allergy . 1989 ;44 (suppl 9 ):79 -83 .
22.
22.
Barton LL
,
Friedman AD
. Impetigo: a reassessment of etiology and therapy . Pediatr Dermatol . 1987 ;4 :185 -188 .
23.
23.
Coskey RJ
,
Coskey LA
. Diagnosis and treatment of impetigo . JAm Acad Dermatol . 1987 ;17 :62 -63 .
24.
24.
Jain A
,
Daum A.
Staphylococcal infections in children: Part I . Pediatr Rev . 1999 ;20 :183 -191 .
25.
25.
Rahman M
,
Noble WC
,
Cookson B.
Mupirocin-resistant Staphylococcus aureus . Lancet . 1987 ;2 :387 -388 .
26.
26.
Blondel-Hill E
,
Fryters S
, eds. Bugs and Drugs . Edmonton, AB : Capital Health ; 2000 :71 -71 .
27.
27.
Salasche SJ
,
Tran TA
,
Parlette HL III
. Surgical pearl: removal of a large labial mucocele . J Am Acad Dermatol . 1999 ;40 :760 -762 .
28.
28.
Rice DH
. Salivary gland disorders. Neoplastic and nonneoplastic . Med Clin North Am . 1999 ;83 :197 -218 .
29.
29.
Yamasoba T
,
Tayama N
,
Syoji M
, et al. Clinicostatistical study of lower lip mucoceles . Head Neck . 1990 ;12 :316 -320 .
30.
30.
Cataldo E
,
Mosadomi A.
Mucoceles of the oral mucous membrane . Arch Otolaryngol . 1970 ;91 :360 -365 .
31.
31.
Strader RJ
. Review of a technique in the treatment of mucoceles . Oral Surg Oral Med Oral Pathol . 1974 ;37 :695 -698 .
32.
32.
Delaney JE
,
Keels MA
. Pediatric oral pathology. Soft tissue and periodontal conditions . Pediatr Clin North Am . 2000 ;47 :1125 -1147 .
33.
33.
Rothfleisch JE
,
Kosann MK
,
Levine VJ
,
Ashinoff R.
Laser treatment of congenital and acquired vascular lesions. A review . Dermatol Clin . 2002 ;20 :1 -18 .
34.
34.
Wirth FA
,
Lowitt MH
. Diagnosis and treatment of cutaneous vascular lesions . Am Fam Physician . 1998 ;57 :765 -773 .
35.
35.
Jacobs AH
,
Walton RG
. The incidence of birthmarks in the neonate . Pediatrics . 1976 ;58 :218 -222 .
36.
36.
Jacobs AH
. Strawberry hemangiomas: the natural history of the untreated lesion . Calif Med . 1957 ;86 :8 -10 .
37.
37.
Amir J
,
Metzker A
,
Krikler R
, et al. Strawberry hemangiomas in preterm infants . Pediatr Dermato L
1986 ;3 :331 -332 .
38.
38.
Schoen FJ
,
Cotran RS
. Blood vessels . In:
Cotran RS
,
Kumar V
,
Collins T
, eds. Robbins: Pathological Basis of Disease , 6th ed.
Philadelphia : W.B. Saunders Company ; 1999 :493 -541 .
39.
39.
Tanner JL
,
Decher MP
,
Frieden IJ
. Growing up with a facial hemangioma: parent and child coping and adaptation . Pediatrics . 1998 ;101 :446 -452 .
40.
40.
Kushner BJ
. The treatment of periorbital infantile hemangioma with intralesional corticosteroid . Plast Reconstr Surg . 1985 ;76 :517 -526 .
41.
41.
Sloan GM
,
Reinisch JF
,
Nichter LS
, et al. Intralesional corticosteroid therapy for infantile hemangiomas . Plast Reconstr Surg . 1989 ;83 :459 -467 .
42.
42.
Ezekowitz RA
,
Mulliken JB
,
Folkman J.
Interferon alfa-2a therapy for lifethreatening hemangiomas of infancy . NEngl JMed . 1992 ;326 :1456 -1463 .
43.
43.
Landthaler M
,
Hohenleutner U
,
el-Raheem TA
. Laser therapy of childhood haemangiomas . Br J Dermatol . 1995 ;133 :275 -281 .
44.
44.
Fishman SJ
,
Mulliken JB
. Hemangiomas and vascular malformations of infancy and childhood . Pediatr Clin North Am . 1993 ;40 :1177 -1200 .
45.
45.
Enjolras O
,
Mulliken JB
. The current management of vascular birthmarks . Pediatr Dermatol . 1993 ;10 :311 -313 .