Lip tissue breaking down, dry, stretched, chapped, dark

[Hard2Luv]

I had an incident a while back, that caused this.
And it would be either from being active with genital hsv2
or some kind of permanent  ?allergic? reaction to a body lotion, both which may have touched my lips.  

At the time, some black spots ocurred on my lips and I think I even had one burned off by a dermatologist.  
Since then, I've gotten very deep chapping and dry lips, almost like an external layer of dry skin is on them.

Really only photos, can show this.  I hope you can see, and a medical professional can comment.  
Is this permanent condition ?    from allergic reaction or  HSV2 - Herpes ?   Is there treatment ?

http://imgur.com/JOokgGo,buo6Mml   June, 2013
http://imgur.com/zh0z4Nj,CNqcE1I,eHHxqe5,22ce0hw,5Fr6zRd,ELWZj9V  

I'm hoping to find answers, thank you.

[Hard2Luv]

What is the diagnosis and treatment steps ?
I'm assuming it would be expensive, but might be covered under insurance.
thank you for your reply

[Bhupinder Kaur, MD]

Hello,
Thanks for posting your query.

I have checked the photographs and can understand your concern for these symptoms.

From the symptoms and photographs, two possibilities which are necessary to be ruled out are:

1) Actinic cheilitis: It is a precancerous condition most often affecting the lower lip and is found in elderly men and there is an association between this disease and smoking. It is caused by chronic exposure to the sun’s UV rays and poor oral hygiene may be another risk factor. Symptoms include dry chapped lips, thinning skin on the lips, scaly patches, ulcers or crusting on the lips, swelling of the lip, redness or soreness of the lips and loss of demarcation between the border of the lip and the surrounding skin. Any or some of these symptoms may be present in patients.

2) Second possibility is of cheilitis which is inflammation of the lips. In a variety of cheilitis; i.e exfoliative cheilitis which is an inflammatory condition of the vermillion zone of the lips, the lips are painful and crusted. There is continuous production and desquamation (shedding) of thick, brown scales.


It is less likely to be due to herpes infection which causes herpes labialis or herpetic gingivostomatitis; both of which are less likely to cause such symptoms. You have not mentioned the incident which initiated these symptoms but cryotherpy/ electrocautery may have been used for herpes sores/ warts or some benign lip lesions.

What exactly it is can be confirmed only after a clinical examination and a biopsy of the lip scrapings. Skin biopsy is essential to rule out any actinic cheilitis just to make sure you haven’t developed squamous cell carcinoma. Treatment is diagnosis specific and depends on the confirmation of diagnosis.

Hope that this information helps and hope that you will get better soon.

Wishing you good health.