44/M having recurrent lesions on lower lip since last 8-9yrs. Recurrence every 3-4mnth. Burning sensation present locally Oozing+ Swelling+ bleeding mild+ No H/O fever/itching. Relieves every time wid local application f chlorhexidine. K/C/O cigarette smoking/ tobacco chewing since 25yrs No H/O Dm/HTN Kindly diagnose d case n help wid Rx. @@Dr. Hemant Adhikari @Dr. Hanumanthappa Hulugappa @Dr. P.kishore Kumar @Dr. Sunita Shelke ( Kude) @Dr. S. Dhara @@Dr. Amitabha Dasgupta @Dr. Partha Sarathi Sahana @

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Ulcerative Actinic Cheilitis Ulcerative Actinic LP Cheilitis Glandularis  Recurrent Herpes Labialis Eczematous Cheilitis Discoid Lupus Cheilitis Etc. * Seek opinion of dermatologist & oral pathologist. Respected Dr.Asv Prasad Sir requested to kindly guide.

Thnx sirjee!
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Dear Dr ParthaSarathi Sir, Thanks for taging. The lesions are chronic (8yr) and recurrent every eto 4 months. A lose look at the pictures especially, rhe second one u can notice shallow ulcers on either end of lip with yelloish necrotic floor-just looking like the apthous ulcers. But that much chronicity and regular recurrence an dseverity suggests "BAH CET'S DISESSE THE UNEXPORED AREAS HISTORY- WISE AND EXM -WISE IS GENITAL ULCERATION . RESONS APART FROM ABOVE COULD BE MALE PT VS FEMALE DOCTOR ! OR PT MIGHT THINK AS NOT RELEVANT. SO OROGENITAL CHRONIC TECURRENT APTHOUSIS FIT'S INTO BAHCET'S. SINCE IT IS AN AUTO IMMUNE , MULTISYSTEM DISEASE WHAT SEEMINGLY LOOK LIKE UNRELATED COMPLAINTS LIKE THAT OF EYE, JOINTS ETC MAY BE OVER LOOKED OR MIGHT NOT HAVE BEEN INVOLVED SO FAR. SO A THOROUGH FOR BAHCET'S IS WARRENTED FROM VARIOUS SPECIALISTS CONCERNED. IT IS DARINDG TO THINK OF LESIONS UNDER THE TROUSER, BUT IF U SUSPECT , U WILL NEVER LEAVE ANY STONE UNTURNED. APART FROM MY POSITIVE APPROCH, THE DIAGNOSIS IS CONSIDERED AFTER EXAMINING THE MERITS OF OTHER POSSIBILITIES SUGGESTED. BOTH ACTINIC CHEILITIS AND DLE WHERE UV RAYS ARE IMPLICATED COULD BE AT THE WORST BE SEASONAL BUT NOT RANDOMLY RECURRENT LESIONS. NO AGRAVATION BY SUN LIGHT IS SUGGESTED. THE MORPHOLOGY DESCRIBED DOENOT FIT INTO EITHER DISEASES. HERPETIC AETIOLOGY IS UNLIKELY AS THE LESIONS WOULD BE GROUPED AND MORE COMMONLY INVOLVRE MUCO-CUTANEOUS JUNCTIONS. GRANULOMATOUS CHELITIS CAUSES SWELLIND ( LYMPH OEDEMA) THAN ULCERATION WITH REGULAR RECURRENCE. OTHER SUGGESTIONS ARE NOT WORTH MENTIONING. HENCE MY DIAGNOSIS OF BECEHT'S DISEASE. I THANK DR SHINY ALSO FOR THE PREFERENCE GIVEN AND RESERVING HER THANKS WHICH SHE IS VERY PROMPT. I MAY BE WRONG BECAUSE I AM PLAYING BLIND !

Thnx a lot for such a thorough description sirjee!
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Actinic cheilitis.. Actinic keratosis of lip Solar keratosis Solar cheilosis Better to do biopsy for further management

Thnx A lot sirjee!
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Recurrent Herpes labialis. Ulcerative Actinic Chelitis.

Thnx sirjee!
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Herpes labiasis? Actinic chelitis Biopsy needed

Thnx sirjee!
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Herpes labialis

Recurrent Herpes labialis, however biopsy to exclude malignancy considering smoking and tobacco chewing.

Thnx sirjee!
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Actinic cheliosis

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? Acnetic Cheilitis

Thnx sirjee! Rx??
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Herpes labialise with irritant dermatitis (?chlorhexadine)

Thnx sirjee!
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