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PDT - Continued by Michel84 ..... Peeling Lips Exfoliative Cheilitis

Date:   2/19/2012 7:07:46 AM ( 10 years ago ago)
Hits:   2,357

Hi all,

3 weeks ago I went to the dermatologist to discuss PDT as a treatment option of photodynamic therapy (PDT) to treat EC. They insisted on taking a biopsy to find indications that PDT would help for EC (the most important indication is that sunlight/ UV-induced damage must be present, which is only the case in actinic cheilitis). This is mostly important for the insurance company, as they wont pay for the treatment when there is no evidence that it could help.

They took a 5 mm deep, 3 mm wide punch biopsy from the vermillion border of my lips.
Last week I went to get the results from that biopsy by the pathologic anatomical department. In short, they found excessive skin growth/ hyperkeratosis, no inflammation (!) or even any signs of inflammation, and parakeratosis. They didn't find significant numbers of immune cells, the basal membrane underlying the epidermis (upper skin layer) was intact, and no excessive number of capillaries/ blood vessels were found.

This struck me as odd, as I was sure I would have some form of cheilitis, however, after about 2 - 2,5 years the inflammation appears to have subsided after complete avoidance of White Sugar , white flower, and pork meat.
Skin growth was still present: the dermatologist (a promoted, senior one) mentioned that the skin regrowth cycle I mentioned was completely to be expected. Normal skin also has a cycle of 5 days - 1 week, only that the number of skin cells peeling off is much lower and not really in layers.

Unfortunately the doctors/ anatomics department hasn't made any histologic (magnified tissue) pictures of my skin. Perhaps I can still ask for the prepared microscopic slides to see for myself.

They mentioned that curing of such a noninflammatory condition should be relatively simple. According to them, some external (they said that this type of skin growth/ histology would not be caused by internal factors (?)) irritating factors cause continued skin buildup to compensate. I sporadically bite off small bits of exfoliated lip skin, so this could perhaps be true. However, in the past I have tried applying vaseline etc. for like 1,5 years to no avail. However, in those days I am sure my skin was still inflamed, as it was much more sensitive/ red and perhaps swollen. The peeling cycle was about the same.

So, they recommended to leave my lips completely alone (as several of you guys are trying), and to help it they prescribed some ointments to discourage myself from harming them. The ointments are themselves not going to help much (only to keep them moist/ prevention of drying). The ointments are: 1) Hypoallergenic cooling-cream (Fagron); 2) Cetomacrogol- cream FNA (Fagron). Both contain waxes, paraffin/ vaseline/ oils.

I agreed to their recommendations, because of the absence of inflammation (I think internal factors are unlikely to be a factor in my particular case (NOT general). I think internal irritants/ immunogens nearly always lead to the formation of immune-cell invasion, increasing blood flow & number of capillaries etc. Perhaps more likely is the concept that quick drying out of the skin, physical harm and increased susceptibility to irritation are causing my particular form of Exfoliative non-cheilitis.

I will try this out for ~4 months to see if it helps. Sorry for the long post, but I wanted to be thorough on this one, so we may be better able to understand EC.

Best of luck to all!

PS. Of course, if you have enough money, you can just try out PDT (it's a safe enough treatment that at least dermatologists wont object to it). The cost is steep - a daytreatment will cost between 500 - 1200 euro's, and chances are likely you will need 1 - 3 treatments to treat EC completely, if it works at all (which I think it will).


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