GP Quiz 30 – Case 1
What is the name for the skin condition?
Cheilitis i.e. sore, swollen, dry and cracked lips.
What medications may be responsible?
Retinoids, particularly isotretinoin, which is sebostatic, causing dry lips in every treated patient, even those taking small doses.
What management would you recommend?
Advise the patient to apply lip balm frequently and to avoid lip licking. The dose of isotretinoin may need to be reduced, or it may be discontinued for a few days until the cheilitis has resolved. Swabs may culture Staphylococcus aureus, which may be treated with topical antiseptic for a few days e.g. hydrogen peroxide cream (Crystacide™). Oral antibiotic may be required for more severe infection.
This quiz was also published by New Zealand Doctor in July 2007.


