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Definisi

Cheilitis merupakan istilah umumuntuk inflamasi pada merah bibir

Cheilitisdibagi menjadi beberapa tipe:

angular cheilitis, actinic cheilitis,contact cheilitis, plasma cell cheilitis,

cheilitis glandularis, cheilitis

granulomatosa, exfoliative cheilitisandfactitious cheilitis

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Cheilitis contact merupakan reaksiinflamasi pada bibir yang dipicu oleh

iritan atau aksi sensitisasi bahan kimiayang berkontak langsung denganbibir.

Bahan yang dapat menyebabkaniritasi pada bibir: saliva, lipstik,lipgloss, gigitiruan, bahan tambalangigi, makanan dan pengawet

makanan Juga berhubungan dengan pekerjaan

atau hobi tertentu.

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Epidemiologi

Hasil penelitian The North AmericanContact Dermatitis Group (NACDG)

pada periode tahun 2001 sampai

2004, menunjukkan bahwa dari 196pasien cheilitis, 38.3 % adalah

penderita Cheilitis contact

Wanita lebih sering terkena dibandinglaki-laki

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Patogenesis

Cheilitis contact termasuk reaksihipersensitivitas tipe IV

Reaksi hipersensitivitas tipe IV disebut

juga tipe lambat (terjadi lebih dari 12jam) setelah terpapar antigen

Melibatkan limfosit T (seluler)

Bahan alergen disebut hapten yangkemudian akan berikatan dengan

protein sehingga dapat dikenali

sebagai antigen

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Proses seluler pada reaksihipersensitivitas tipe IV melibatkan

limfosit T dan makrofag. Pertama,respon imun dan inflamasi lokal padadaerah yang terpapar antigenmenyebabkan ekspresi molekul

adhesi sel endotel yang memicuakumulasi lekosit pada jaringan.

Antigen di fagosit oleh makrofag

kemudian dipresentasikan kepada selT sitotoksik (CD8+).

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Sitokin akan menyebabkanpermebilitas kapiler lokal yang

menyebabkan edema

CD8 dan enzim hidrolitik darimakrofag akan menyebabkan

kerusakan dan nekrosis jaringan

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Gambaran Klinis

Letak: Cheilitis contactbiasanyaterbatas pada tepi merah bibir tapi

sering juga meluas.

Tanda dan gejala: terdapat iritasipersisten dan pengelupasan atau

reaksi akut dengan kemerahan,

edema dan vesikula serta bibir terasakering, terbakar atau gatal.

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Gambar 1. Contact cheilitisakibat lipstik yangmenunjukkan adanya edema. Sumber: Ghom, A.G.

(2010)

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Diagnosis

Jika dalam kondisi akut, diagnosischeilitis contactdapat dilakukan

berdasarkan gambaran klinis.

Pemeriksaan laboratorium yang dapatdilakukan adalahpatch test

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Diagnosis Banding

Actinic cheilitis

Irritant contact

cheilitis

Seborrheicdermatitis

Dermatitis

perioral Oral lichen planus

atau oral lesion

lichenoid

Cheilitis infeksi

Sifilis sekunder

Herpes simpleks

Ulser aphthous

Bullous disease

Defisiensi nutrisi

Cheilitis

glandularis

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Terapi

Menghindari faktor penyebab reaksialergi

Terapi simptomatis dengan

kortikosteroid topikal (triamcinoloneacetonide 0,1 %).

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Referensi1. Ghom, A.G. (2010) Textbook of oral medicine. 2nded. New

Delhi: Jaypee Brothers Medical Publishers (P) Ltd.p: 566

2. Wieckowicz, A.R. et al (2011) Cheilitis-case study and

literature review Post Dermatol Alergol, 28:(3), p: 231-9.

[Online]. Available at: http://www.termedia.pl/Case-report-

Cheilitis-case-study-and-literature-review,7,16943,1,1.html.

(Diakses: 12 Mar 2014).

3. Jacob, S.E. and Herro, M.E. (2011) Allergic contact

cheilitis The Dermatologist, 19:(8), p: 18-22. [Online].

Available at: http://www.the-

dermatologist.com/content/allergen-focus. Diakses: 13 Mei

2014.

4. Bakula, A. et al. (2011) Contact allergy in the mouth:

diversity of clinial presentations and diagnosis of common

allergens relevant to dental practiceActa Clin Croat, 50,

p:553-561. [Online]. Available at: http://www.acta-

clinica.kbcsm.hr/arhiva/Acta2011/Acta4/16.pdf. Diakses: 13Mei 2014.

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