An Overview EC

Before directly jumping to the treatment it is important to understand the disease first. You may be familiar with the information I provided below. I have tried to explain what actually the disease is in a simplified manner.
EXFOLIATIVE CHELITIS [peeling lips, lip psoriasis]- It is a chronic inflammatory condition of lips in which skin of lip peels completely in cyclic manner.
This condition is like a syndrome and has very close resemblance with chronic inflammatory diseases like psoriasis, arthritis, etc. and syndrome like Steven-Johnson syndrome. In medicine a syndrome is the association of several clinically recognizable features, signs, symptoms, characteristics that often occur together. So peeling lip is basically one of symptom rather than a disease itself. Peeling lips are very noticeable than other symptoms and we consider peeling lip as an individual disease and undergo treatment exclusively for peeling lips. So treatment may be incomplete or deficient and results in failure. The syndrome has following characteristics.
Symptoms
• Dry, scaly, thin and itchy skin.
• Poor muscle tone, Muscle cramps and joint pain.
• Depression, irritability, difficulty in concentration, etc.
• Fatigue.
• Reduced salivary flow.
• Frequent mucosal ulceration.
• Resistant dandruff.
• Resistant acne.
• Constipation.
• Allergic reactions.
• Peeling lips.
All above symptoms are resulted due to collective effect of depressed immunity, impaired liver functioning, G.I. disturbance, hormonal imbalance, etc. All symptoms are not necessarily noticeable in every patient but they exists. As peeling lips are very noticeable other symptoms are easily ignored. The possible causes for above condition are as below.
Etiology
• Nutritional deficiency- It is the main cause. It causes defective keratin formation. It is of two types
1. Primary deficiency – It is due to long term deficient diet of nutrients. It is not very common reason.
2. Secondary deficiency – It is due to malabsorption in intestine. It is common reason for deficiency.
Deficiency may be vitamins, omega amino fatty acid, minerals like zinc, etc.
• Depressed immunity- It is caused due to persistent stress for long period, viral infection, long term steroid therapy etc. and it causes opportunistic infection like bacterial, fungal, etc.
• Antibiotic therapy – long term antibiotic therapy or use of contraceptives may cause microbial imbalance in body.
• Sunburn – chronic exposure to sun which is common in players, farmers, etc.
• Chronic illness
• Accidental illness.
• Emotional disturbance.
• Autoimmunity – due to our hyperactive defense system cheilitis may occur.
• Allergy – hypersensitivity to certain substances from food, drink or toothpaste may cause EC but it is extremely rare.
• lifestyle
pathophysiology
Defective keratin
For the formation of any healthy substance in body some essential factors are required in proper amount. If these factors are deficient not present then resultant substance may be defective or completely absent. Similar phenomenon occurs during keratin formation. Keratin is a protein synthesized in body. If factors required for keratin formation are deficient then they are utilized from the storehouse of nutrients in body i.e. liver but if this deficiency persists for longer period then it causes emptying of all stored houses. And here starts a no ending chain of defective keratin. Along with lips, hairs, skin of scalp, nails, may also be affected as all those tissues require keratin. Lack of these factors also affects production collagen, some hormones, and enzymes. It is also seen that sebum and sweat production also affected. That may be the reason that many of us have complaints like uncontrolled dandruff, tiredness, hormonal imbalance, frequent ulceration, delayed wound healing, depression, etc. so
What causes defected keratin? The answer is-
1. it acts as very good substrate for oral bacteria and fungi to grow so further inflammation. In viral infection or depressed immunity condition these infections penetrate dangerously.
2. It is detected as a foreign body by our defense system. This causes inflammation around tissue and our body tries to detach it from healthy tissue.
By this way never ending cycle starts as tissue is formed soon rejected by immune system of body simultaneously attacked by oral bacteria, fungi or viruses.
As considering a very complex nature of disease treatment has to be planned very systematically for each patient as there is no universal treatment which is applicable for every patient.