We wished to ascertain the most common allergens causing allergic contact cheilitis in Melbourne, and conducted a retrospective study of our database of patients patch tested from 1993 to 2017.
Of the 141 patients identified with cheilitis, 61 (43.3%) were diagnosed with allergic contact cheilitis; 13 (9.2%) were diagnosed with irritant contact cheilitis; 48 (34%) were diagnosed with endogenous cheilitis, 5 (3.5%) were classified as unknown and 14 (9.9%) from other causes. The most common relevant allergens were (in order) myroxylon pereriae (Balsam of Peru), fragrance mix, Amerchol L-101 (lanolin), nickel, fragrance mix 2, dodecyl gallate, peppermint oil, spearmint, sodium fluoride and palladium chloride. In comparison with the overall allergens causing allergic contact dermatitis, certain allergens were more associated with allergic contact cheilitis. These included myroxylon pereriae, Amerchol L101, dodecyl gallate, peppermint, sodium fluoride, coriander, butylated hydroxyanisole, menthol and sodium benzoate. Many of these allergens are not included in the Australian Baseline Series, so we have used these results to propose an evidence-based patch test screening series for the investigation of cheilitis.
In summary, fragrances, flavours in lip cosmetics and/or tooth paste, preservatives and antioxidants were the common allergens in allergic contact cheilitis.