Lip furuncle L02.0

Boils on the upper lip, or more rarely on the lower lip, often occur during puberty as a complication of acne, usually accompanied by severe swelling and oedema of the lips.

Lip furuncles tend to transform rapidly into phlegmonous furuncles, with only a slight tendency to melt in. Extensive collateral oedema of the lips and the wider environment develops, with possible systemic signs such as fever, chills, clinical signs indicating septic progression of the infection.

• Folliculitis simplex: superficial infection of the follicle (ostiofolliculitis). Pustule formation around a hair shaft.
• Infected epidermoid cyst: painful, inflammatory nodule that develops suddenly, usually after an attempt to squeeze it out.
• Lymphomatoid papulosis: slowly growing painless nodule. No abscess formation. Diagnosis: biopsy.
• Trichophytia profunda: furunculous nodule, usually in children, usually capillitium; minor painfulness. Diagnosis: biopsy.
• Furunculoid myiasis: for Central Europeans, this is a typical traveler's dermatosis. Slow growing. No significant pain.
• Leishmaniasis: slowly developing nodule, only slight painfulness. Travel history. Diagnosis: Biopsy with pathogen detection.

In upper lip furuncles there is a (rare) risk of thrombophlebitis of the vena angularis and the sinus cavernosus with cavernosus thrombosis and purulent meningitis.

Rare is the development of a conglomerate furuncle with opening into the oral mucosa.

No manipulations! Immobilization, bed rest, no talking or chewing. Correspondingly, a soft, pasty diet is recommended. Furthermore: damp, warm, antiseptic compresses (Octenidin 1%).

In case of demarcation, incision of the abscess, drainage and irrigation (e.g. with polyvidon iodine solution) drainage by strip insertion with iodoform strips.

Systemic antibiotic therapy: in case of lip furuncle, in-patient IV therapy with antibiotics is indicated. The antimicrobial spectrum of the antibiotic must be based on the antibiotic sensitivity of Staphlycoccus aureus.

In upper lip furuncles there is a (rare) risk of thrombophlebitis of the vena angularis and the sinus cavernosus with cavernosus thrombosis and purulent meningitis.

1. Hoede N et al (1967) Conglomerates furuncle in the area of the lower lip with perforation into themouth. Med World 24:1492.
2. Yusuf MA et al. (2019) Cutaneous myiasis in an elderly woman in Somaliland. Int J Womens Dermatol 5:187-189.