A 14-year-old boy presented with insidious onset of diffuse swelling of the lips with eversion of lower lip (Fig. 1), burning sensation and sticking of the lips due to glue-like secretions, especially in the morning and on sun exposure. The lower lip was swollen; patulous opening of the ducts of the minor salivary glands were visible. Palpation revealed expression of mucous fluid from the minor salivary glands and a pebble-like feeling. A clinical diagnosis of chelitis glandularis simplex was made for the patient.

Fig. 1 Swollen, everted and dry lower lip.

Cheilitis glandularis is a rare inflammatory condition of the　minor salivary glands, usually affecting the lower lip. The delicate lower labial mucous membrane is secondarily altered by environmental influences, leading to erosion, ulceration, crusting, and, occasionally, infection. The openings of the minor salivary gland ducts become inflamed and dilated, and there may be mucopurulent discharge from the ducts. It carries a risk of (18% to 35%) malignant transformation to squamous cell carcinoma. Preventive treatment such as vermilionectomy (lip shave) is the treatment of choice. Intralesional steroids, minocycline and tacrolimus ointment are the other treatment modalities. The clinical differentials include actinic chelitis (scaling, fissuring without any pebble-like feel or exudation of mucus on pressing), granulomatous chelitis (permanent swelling of lip; without ulceration, scaling or fissuring or pebble-like feel) and chelitis exfoliativa (scaling, crusting, more commonly involves upper lip).