Three Cases of 'Morsicatio Labiorum'

Abstract

Morsicatio labiorum is a form of tissue alteration caused by self-induced injury, mostly occurring on the lips, and is considered to be a rarely encountered mucocutaneous disorder. Clinically, it is a macerated grey-white patch and plaque of the mucosa caused by external stimuli (self-induced injury) such as habitual biting, chewing, or sucking of the lip. It is often confused with other dermatological disorders involving the oral mucosa, which can lead to a misdiagnosis. We herein report three cases of morsicatio labiorum; two cases were misdiagnosed as exfoliative cheilitis at the time of the first visit.

Oral White Lesions: An Updated Clinical Diagnostic Decision Tree

“…The prevalence of morsicatio has been reported 0.5% to 1.12% among the general population with a male to female ratio of 1/3. This condition is more common in patients older than 35 years, and those having extra stress or mental illness [4,5,21]. The most affected areas are non-keratinized epithelium of the buccal mucosa (morsicatio buccarum), lips (morsicatio labiorum), and the lateral borders of the tongue (morsicatio linguarum), respectively.…”

“…The most affected areas are non-keratinized epithelium of the buccal mucosa (morsicatio buccarum), lips (morsicatio labiorum), and the lateral borders of the tongue (morsicatio linguarum), respectively. Morsicatio does not involve areas not achievable to habitual chewing trauma [4,5,14,21]. While the lesions usually present bilaterally on the mid-portion of anterior buccal mucosa along the occlusal line extensive lesions may involve larger areas of buccal mucosa.…”

“…The clinical features include asymptomatic shaggy and thickened macerated gray-white patches or plaques with keratin shreds, tissue tags, or desquamated areas on the mucosal surface, which gradually merge the adjacent mucosa [4,14,21]. A peeling irregular ragged surface with erythema or erosion—but not ulceration—might accompany white areas, and the patient may report the ability to peel shreds of the white portion from the periphery of the lesions [4,5,21]. If the clinical presentation of morsicatio is typical and history taking reveals patients’ habit of mucosal biting the diagnosis will be established.…”

“…If the clinical presentation of morsicatio is typical and history taking reveals patients’ habit of mucosal biting the diagnosis will be established. In case of any doubt, a biopsy seems to be necessary [4,5,21]. This condition has no long-term negative consequences and generally no treatment is recommended.…”

Diseases of the lips

“…Morsicatio labiorum is more frequently noted on the lower lip than on the upper lip and presents with shredded or verrucous white plaques, zones of erythema, and erosions. 26 The shredded epithelium may be peeled off by the patient resulting in further trauma and ulceration. Frequently, the…”