Lip Fold Dermatitis

Overview

Lip fold dermatitis or pyoderma is a skin infection and inflammation that occurs between close skin surfaces, usually on the lower lip. Skin folds often have reduced air circulation, increased moisture, and increased warmth, which promotes bacterial overgrowth. This is then compounded by the introduction of bodily secretions such as tears, saliva, and urine that further promote microbial overgrowth and infection. Other influences include obesity, allergies, and hormones.

It occurs commonly on the lip but can also occur in other parts of the body such as the tail.

Large lip flaps are a common predisposing factor with hypersalivation adding to the problem.

It is a problem commonly seen in these breeds:

• St. Bernard
• Cocker Spaniel
• English Bulldog
• French Bulldog
• Pug
• Pekingese
• Basset hound
• Bloodhound
• Shar-Pei

Signs

• Redness
• Discharge or weepiness
• Odours
• Thickened skin
• Bad breath
• Scratching and rubbing at the face

Management

The goal of treatment is to resolve inflammation, infection, and excessive moisture. Long-term medical management should be expected and in most cases very successful. 

Treatment of skin fold pyodermas may include:

• Wiping the affected folds twice daily with antimicrobial wipes
• Antibiotic ointment e.g. mupirocin twice daily after wipes
• Use of sprays or shampoos for more extensive lesions
• Topical silver sulfadiazine
• Topical or oral steroids for anti-inflammatory effects

Recurrence is likely so regular monitoring and early intervention are required to prevent serious lesions. 

In severe cases, lip fold resection surgery (cheiloplasty) may be required.

Dental care is particularly important in cases of lip fold dermatitis as it provides a constant source of bad bacteria. If there is concurrent dental disease, both conditions will require treatment.