Annales de dermatologie et de venereologie · 2009
[Cheilitis: a new manifestation of gastro-oesophageal reflux?].
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Mathelier-Fusade P
Аннотация
BACKGROUND: Gastro-oesophageal reflux (GOR) is a common disease. Extra-oesophageal clinical signs associated with the disease and affecting the ENT (otitis media, rhinitis, laryngitis), pulmonary and stomatological spheres have been described for a number of years. We report three cases of cheilitis potentially attributable to GOR.
CASE REPORT: Three female patients consulted for cheilitis present for several months. Screening for an infectious cause was negative, as was allergological investigation using skin tests. However, questioning revealed nocturnal breathing through the mouth in all three patients as well as symptomatic GOR in one patient. Test therapy comprising proton-pump inhibitors was proposed and after 1month symptoms had subsided completely. Gastro-oesophageal endoscopy performed in the subsequent weeks revealed oesophagitis in all patients.
DISCUSSION: Extra-oesophageal signs described during the course of GOR mainly affect the ENT sphere and pulmonary sphere (cough, asthma) and are doubtless due to the direct caustic action of gastric secretions on the mucus membrane. Although gastroenterological investigation (endoscopy, 24-h pHmetry) may be negative, treatment with proton-pump inhibitors results in complete resolution of symptoms. The cases we describe suggest for the first time that extra-oesophageal sites affected by GOR may include the labial semimucosa.
CASE REPORT: Three female patients consulted for cheilitis present for several months. Screening for an infectious cause was negative, as was allergological investigation using skin tests. However, questioning revealed nocturnal breathing through the mouth in all three patients as well as symptomatic GOR in one patient. Test therapy comprising proton-pump inhibitors was proposed and after 1month symptoms had subsided completely. Gastro-oesophageal endoscopy performed in the subsequent weeks revealed oesophagitis in all patients.
DISCUSSION: Extra-oesophageal signs described during the course of GOR mainly affect the ENT sphere and pulmonary sphere (cough, asthma) and are doubtless due to the direct caustic action of gastric secretions on the mucus membrane. Although gastroenterological investigation (endoscopy, 24-h pHmetry) may be negative, treatment with proton-pump inhibitors results in complete resolution of symptoms. The cases we describe suggest for the first time that extra-oesophageal sites affected by GOR may include the labial semimucosa.