An updated understanding of allergic contact cheilitis is needed.
To characterize clinical characteristics and allergen relevance in patients with cheilitis referred for patch testing.
Retrospective analysis of 43,772 patients patch tested with the North American Contact Dermatitis Group (NACDG) screening series from 2001-2018.
Overall, 2094 patients (4.8%) had lips as one of three sites of dermatitis, 1583 (3.6%) had lips as the primary site, and 1167 (2.7%) had lips as the sole site of dermatitis. Prevalences of cheilits at any, primary, and sole sites significantly increased throughout the study cycle from 2001-2002 (2.7%, 2.2%, and 1.7%) to 2017-2018 (7.8%, 5.2%, 3.7%). Approximately 60% of patients with any, a primary, or a sole site of cheilitis had one or more positive allergic patch-test reactions compared to 65% of those without cheilitis.
Patients with cheilitis who were referred for patch testing had high rates of positive and relevant allergens. More than 1 in 4 patient with any, primary, or sole cheilitis had a positive reaction to non-NACDG screening allergens (28.0%, 26.8%, 31.1% vs 21.6%) compared to patients without cheilitis, emphasizing the need for expanded patch test series in cheilitis.

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