What is the differential diagnosis (Ddx) for perioral (around the mouth) erythema (redness) and dryness with wheal-like lesions?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 11, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Peri-lip Erythema and Dry, Wheal-like Lesions

  • Single most likely diagnosis:
    • Contact Dermatitis: This is a common condition that can cause erythema, dryness, and wheal-like lesions around the lips due to an allergic reaction or irritation from substances like cosmetics, food, or metals.
  • Other Likely diagnoses:
    • Atopic Dermatitis (Eczema): Characterized by dry, itchy, and inflamed skin, which can include the peri-lip area, often associated with allergies or asthma.
    • Irritant Contact Dermatitis: Similar to contact dermatitis but caused by non-allergic irritation from substances like soap, detergents, or extreme weather conditions.
    • Angular Cheilitis: Inflammation of the corners of the mouth, which can extend to the peri-lip area, often due to fungal or bacterial infections, and can cause erythema and dryness.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Lupus: Systemic lupus erythematosus can cause a butterfly-shaped rash across the cheeks and nose but can also involve the peri-lip area, presenting with erythema and potentially more severe systemic symptoms.
    • Sarcoidosis: A condition that can cause skin lesions, including around the lips, and can be associated with more severe systemic disease affecting organs like the lungs and eyes.
  • Rare diagnoses:
    • Melkersson-Rosenthal Syndrome: A rare neurological disorder characterized by recurrent, often unilateral, facial paralysis or weakness, swelling of the face and lips, and the development of folds and furrows in the tongue (fissured tongue), which could initially present with peri-lip erythema and swelling.
    • Granulomatous Cheilitis: A rare condition that can cause swelling, erythema, and dryness of the lips, which might extend to the peri-lip area, often associated with other systemic diseases or as an isolated condition.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.