During a consultation, your doctor will use various techniques in his assesment of the symptom: Lip symptoms. These may include a physical examination or other medical tests. Your doctor may ask several questions when assessing your condition. It is important to remember that your consultation is a two-way process and any extra information you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
Why: to determine if acute or chronic.
Why: e.g. lip pain, cracked lips, lip swelling, lip sores, lip paresthesia, blue lips.
Why: e.g. the lips in cold weather can often feel numb (paresthesia). If symptoms are intermittent may suggest Raynaud's phenomenon.
Why: e.g. Raynaud's phenomenon also causes sequential discoloration of the digits from pallor to blueness to redness upon exposure to cold. When fingers and toes become red they are painful and sometimes feel numb; angioedema may also cause recurrent swelling of the eyelids, mouth and sometimes the internal organs to cause abdominal pain.
Why: may suggest traumatic swelling, traumatic ulcer, mucocele cyst or pyogenic granuloma.
Why: dehydration can cause dry cracked lips.
Why: may indicate a cold sore as the cause of the lip swelling or lip sore or the infection may be associated with erythema multiforme.
Why: insect bite or sting may cause localized lip swelling or angioedema if allergic to bite.
Why: may indicate increased risk of lip cancer or lip burn.
Why: e.g. perfumes, hair sprays, lipsticks etc may cause allergic contact dermatitis.
Why: e.g. hypothyroidism (myxedema); aphthous mouth ulcers may be associated with Behcet's disease, Crohn's disease, celiac disease, HIV disease; angular cheilitis may occur due to Candida infection in people with HIV disease, general debilitation or diabetes mellitus; hypocalcemia may be caused by acute pancreatitis, chronic renal failure, DiGeorge's syndrome, hypoparathyroidism; possible causes of Raynaud's phenomenon include rheumatoid arthritis, lupus erythematosus, systemic sclerosis, polyarteritis nodosa, Buerger's disease, polycythaemia, leukemia, polymyositis , dermatomyositis; hypoparathyroidism is associated with pernicious anemia, Addison's disease, hypothyroidism; Kawasaki disease and Sjogren's syndrome can cause cracked lips.
Why: e.g. immediately following removal of thyroid or parathyroid low calcium levels are usually transient.
Why: some medications are more likely to cause urticaria and angioedema including aspirin, non-steroidal anti-inflammatories, penicillin, radiographic contrast agents, ACE inhibitors, calcium channel blockers, morphine; some medications may cause aphthous ulceration such as gold and steroids; some medications are associated with erythema multiforme including barbiturates, penicillin, sulphonamides, phenothiazines and phenytoin; lichen planus may be induced by some medications including ACE inhibitors, gold, streptomycin, tetracycline, chloroquine, quinine, phenothiazines, penicillamine, chlorothiazide and chlorpropamide; some medications may cause low calcium levels including calcitonin and diphosphonates; beta-blocker blood pressure medications and ergotamine can cause Raynaud's phenomenon; some medications can cause dry cracked lips such as isotretinoin for severe acne.
Why: e.g. foods such as nuts and shellfish, food dyes, food preservatives, medications.
Why: may indicate the risk of syphilis as cause of lip swelling or indicate the risk of HIV which may be associated with angular cheilitis due to Candida infection or aphthous mouth ulceration.
Why: may indicate risk of dietary deficiencies (such as Vitamin B6, B12, folate and iron) that may cause angular stomatitis; Zinc deficiency may cause a dermatitis initially on the face, especially around the mouth.
Why: e.g. hereditary angioedema; hereditary hemorrhagic telangiectasia.
Why: increases the risk of lip and oral cavity cancers.
Sometimes, other symptoms may be present and may help your doctor analyse your condition. These may include:
Why: see lip pain.
Why: see lip swelling.
Why: see lip paresthesia.
Why: see blue lips.
Why: see cracked lips and cracked mouth corner.
Why: would suggest herpes simplex labialis, syphilis and carcinoma.
Why: would suggest herpes zoster (shingles) especially if the rash was unilateral or urticaria if the rash was hive- like.
Why: may suggest tooth socket (alveolar) abscess as cause of lip swelling.
Why: can be associated with dry cracked lips. Salivary secretion tends to fall with age but may also be caused by certain medications, Sjogren's syndrome, dehydration, anemia, vitamin deficiency, diabetes mellitus, HIV infection and radiation therapy.
Why: e.g. prodrome of tingling, itching or burning sensation on the lips which usually precede any visible skin changes by 24 hrs. Prodrome is followed by development of fluid filled vesicles which erode to become ulcers on the lips.
Why: e.g. painless translucent blister-like swelling on the lips or in the oral cavity that is easily ruptured and then drains a clear fluid and then refills.
Why: e.g. red- purple colored nodule less than 1.5cm diameter with smooth surface arising at sites of minor trauma. Often bleeds spontaneously. May develop on fingers, lips, mouth, trunk or toes. Usually occurs in children or adults less than 30 years of age.
Why: e.g. periodically recurring episodes of swelling of the skin, lips, mouth, eyes and sometimes internal organs and brain. Sudden onset and lasts for hours to days. Sometimes associated with joint pain, fever and bruising. Can be life threatening if swelling involves the airways. Seems to be associated with food allergies, urticaria (hives) and possibly stress and emotional factors.
Why: e.g. may range from faint redness to severe swelling, symptoms are often worse in area around the eyes, genitals and on hairy skin, symptoms are least on hairless skin such as palms and soles. Allergic contact dermatitis is usually confined to the site of exposure to the allergen.
Why: e.g. fatigue, lethargy, cold intolerance, constipation, stiffness and cramping of muscles, heavy menstrual periods, slowed motor activity, reduced appetite, increased weight, dry skin, hair loss, deepening of voice, puffy eyelids, thickening of lip.
Why: e.g. cracks at the corners of the mouth. Possible causes may include Vitamin B6, B12, folate and iron deficiency.
Why: e.g. lesions occurring on the inside of the lips or mouth which begin as a small painful vesicle which later breaks down to form the painful shallow ulcer. The ulcers heal without scarring. Cause is unknown, but may occur in Crohn's disease, Celiac disease or AIDS.
Why: e.g. recurrent oral aphthous ulcers, recurrent genital aphthous ulcers, features of posterior uveitis (blurred vision and floaters), erythema nodosum (painful nodules on the arms and legs).
Why: e.g. acute eruption involving the skin and mouth mainly in children, adolescents and young adults. Lesions are raised patches of concentric rings (iris or target lesions). It may be associated with herpes simplex type 1, systemic lupus erythematosus, Hodgkin's disease, myeloma, tuberculosis and some medications.
Why: e.g. itchy shiny purple-colored flat topped plaques mainly on the wrists and legs but may affect the oral cavity with white streaks, papules or ulcers. Cause is unknown, but some medications may induce a lichen planus - like eruption.
Why: e.g. recurrent bleeding nose often in childhood, may have blood stained sputum with coughing, multiple red blood filled spots up to 3 mm in diameter on face, palms, soles, fingers, toes, nail beds, lips and oral cavity.
Why: e.g. sequential discoloration of the digits from pallor to blueness to redness upon exposure to cold. When fingers become red they are painful and sometimes feel numb.
Why: e.g. pins and needles, numbness around the mouth, cramps, anxiety, muscular contractions (tetany). The symptoms may be followed by seizures, stridor and psychosis.
Why: e.g. as for hypocalcemia.
Why: e.g. frequent urination, excessive thirst, weight loss, fatigue - can cause dry mouth and lips.
Why: e.g. fissuring at the corners of the mouth, red inflamed tongue, seborrheic dermatitis on face, scrotum or vagina.
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