We examined a 16-year-old male with persistent crusting of the lips. Biopsy showed parakeratosis, which is a normal feature, and a mild inflammatory infiltrate without fungal infection. These findings are compatible with a diagnosis of exfoliative cheilitis. Medication with antidepressants was helpful. To date, the condition has been reported under various names: factitious cheilitis, localized crusting as an artifact, factitious lip crusting, and exfoliative cheilitis, because some cases are thought to be factitious. We suggest to call this condition ‘factitious type’ or ‘idiopathic type’ of exfoliative cheilitis, respectively, independent of the presence of a psychiatric problem.

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