Vermilion border

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Vermilion border
Erythema around the lips.png
Human lips with the vermilion border outlined. A patch of erythema above the upper lip makes it more difficult to distinguish the vermilion border.
Commissurebeforeandafter.jpg
This left cheek incision extends from the left commissure towards the left ear and it breaches the vermilion border (click to see close-up). In order to maintain aesthetics as best possible, the first suture was placed at or near the vermilion border to ensure a contiguous line upon healing.
Details
Identifiers
Latin pars intermedia labiorum oris
TH H3.04.01.0.00010
Anatomical terminology

The vermilion border (sometimes spelled vermillion border), also called margin or zone, is the normally sharp demarcation between the lip and the adjacent normal skin. It represents the change in the epidermis from highly keratinized external skin to less keratinized internal skin. It has no sebaceous glands, sweat glands, or facial hair. [1] [2]

Contents

It has a prominence on the face, creating a focus for cosmetics (it is where lipstick is sometimes applied) and is also a location for several skin diseases. Its functional properties, however, remain unknown. [3]

Structure

The lips are composed wholly of soft tissue. The skin of the face is thicker than the skin overlying the lips where blood vessels are closer to the surface. As a consequence, the margin of the lips shows a transition between the thicker and thinner skin, represented by the vermilion border. It therefore has the appearance of a sharp line between the coloured edge of the lip and adjoining skin. [4]

It has been described as a pale, white rolled border and also as being a red line. [1] [5]

This fine line of pale skin accentuates the colour difference between the vermilion and normal skin. Along the upper lip, two adjacent elevations of the vermilion border form the Cupid's bow. [6]

Microanatomy

The vermilion border represents the change in the epidermis from highly keratinized external skin to less keratinized internal skin. It has no sebaceous glands, sweat glands, or facial hair. [2] [1]

There are two reasons that the border appears red in some people:

  1. The epithelium is thin and therefore the blood vessels are closer to the surface. [7]
  2. This epithelium contains eleidin which is transparent and the blood vessels are near the surface of the papillary layer, revealing the "red blood cell" color. At the angles of the mouth, there are sebaceous glands, without hair follicles, which are called Fordyce spots. [2] [8]
A Cupid's bow on the upper lip. MouthCupidBow.jpg
A Cupid's bow on the upper lip.

Clinical significance

The vermilion border is important in dentistry and oral pathology as a marker to detect disease, such as in actinic cheilitis. [9]

Associated diseases

Cosmetic appearance

Surgery

A vermilionectomy (sometimes spelled vermillionectomy) is the surgical removal of the vermilion border. It is sometimes performed to treat carcinoma of the lip. [16]

Close attention is given when repairing any injury to the vermilion border. Even 1 mm of vermilion misalignment could be noticeable. [5]

See also

Related Research Articles

<span class="mw-page-title-main">Sebaceous gland</span> Gland to lubricate the hair and skin

A sebaceous gland, or oil gland, is a microscopic exocrine gland in the skin that opens into a hair follicle to secrete an oily or waxy matter, called sebum, which lubricates the hair and skin of mammals. In humans, sebaceous glands occur in the greatest number on the face and scalp, but also on all parts of the skin except the palms of the hands and soles of the feet. In the eyelids, meibomian glands, also called tarsal glands, are a type of sebaceous gland that secrete a special type of sebum into tears. Surrounding the female nipple, areolar glands are specialized sebaceous glands for lubricating the nipple. Fordyce spots are benign, visible, sebaceous glands found usually on the lips, gums and inner cheeks, and genitals.

<span class="mw-page-title-main">Dermis</span> Layer of skin between the epidermis (with which it makes up the cutis) and subcutaneous tissues

The dermis or corium is a layer of skin between the epidermis and subcutaneous tissues, that primarily consists of dense irregular connective tissue and cushions the body from stress and strain. It is divided into two layers, the superficial area adjacent to the epidermis called the papillary region and a deep thicker area known as the reticular dermis. The dermis is tightly connected to the epidermis through a basement membrane. Structural components of the dermis are collagen, elastic fibers, and extrafibrillar matrix. It also contains mechanoreceptors that provide the sense of touch and thermoreceptors that provide the sense of heat. In addition, hair follicles, sweat glands, sebaceous glands, apocrine glands, lymphatic vessels, nerves and blood vessels are present in the dermis. Those blood vessels provide nourishment and waste removal for both dermal and epidermal cells.

<span class="mw-page-title-main">Gums</span> Soft tissue surrounding the roots of the teeth

The gums or gingiva consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health.

<span class="mw-page-title-main">Vellus hair</span> Type of hair that is short, thin, slight-colored, and barely noticeable

Vellus hair is short, thin, light-colored, and barely noticeable hair that develops on most of a human's body during childhood. Exceptions include the lips, the back of the ear, the palm of the hand, the sole of the foot, some external genital areas, the navel, and scar tissue. The density of hair – the number of hair follicles per area of skin – varies from person to person. Each strand of vellus hair is usually less than 2 mm long and the follicle is not connected to a sebaceous gland.

<span class="mw-page-title-main">Stomatitis</span> Medical condition

Stomatitis is inflammation of the mouth and lips. It refers to any inflammatory process affecting the mucous membranes of the mouth and lips, with or without oral ulceration.

<span class="mw-page-title-main">Lip</span> Visible body parts at the mouth

The lips are a horizontal pair of soft appendages attached to the jaws and are the most visible part of the mouth of many animals, including humans. Vertebrate lips are soft, movable and serve to facilitate the ingestion of food and the articulation of sound and speech. Human lips are also a somatosensory organ, and can be an erogenous zone when used in kissing and other acts of intimacy.

The oral mucosa is the mucous membrane lining the inside of the mouth. It comprises stratified squamous epithelium, termed "oral epithelium", and an underlying connective tissue termed lamina propria. The oral cavity has sometimes been described as a mirror that reflects the health of the individual. Changes indicative of disease are seen as alterations in the oral mucosa lining the mouth, which can reveal systemic conditions, such as diabetes or vitamin deficiency, or the local effects of chronic tobacco or alcohol use. The oral mucosa tends to heal faster and with less scar formation compared to the skin. The underlying mechanism remains unknown, but research suggests that extracellular vesicles might be involved.

<span class="mw-page-title-main">Fordyce spots</span> Sebaceous glands that are present in most individuals

Fordyce spots are harmless and painless visible sebaceous glands typically appearing as white/yellow small bumps or spots on the inside of lips or cheeks, gums, or genitalia. They are common, and are present in around 80% of adults. Treatment is generally not required and attempts to remove them typically result in pain and scarring.

<span class="mw-page-title-main">Perioral dermatitis</span> Medical condition

Perioral dermatitis, also known as periorificial dermatitis, is a common type of skin rash. Symptoms include multiple small (1–2 mm) bumps and blisters sometimes with background redness and scale, localized to the skin around the mouth and nostrils. Less commonly the eyes and genitalia may be involved. It can be persistent or recurring and resembles particularly rosacea and to some extent acne and allergic dermatitis. The term "dermatitis" is a misnomer because this is not an eczematous process.

<span class="mw-page-title-main">Angular cheilitis</span> Cheilitis characterized by inflammation of one or both of the corners of the mouth

Angular cheilitis (AC) is inflammation of one or both corners of the mouth. Often the corners are red with skin breakdown and crusting. It can also be itchy or painful. The condition can last for days to years. Angular cheilitis is a type of cheilitis.

<span class="mw-page-title-main">Cheilitis</span> Inflammation of the lips

Cheilitis is a medical condition characterized by inflammation of the lips. The inflammation may include the perioral skin, the vermilion border, or the labial mucosa. The skin and the vermilion border are more commonly involved, as the mucosa is less affected by inflammatory and allergic reactions.

Orofacial granulomatosis (OFG) is a condition characterized by persistent enlargement of the soft tissues of the mouth, lips and the area around the mouth on the face, causing in most cases extreme pain. The mechanism of the enlargement is granulomatous inflammation. The underlying cause of the condition is not completely understood, and there is disagreement as to how it relates to Crohn's disease and sarcoidosis.

Lip reconstruction may be required after trauma or surgical excision. The lips are considered the beginning of the oral cavity and are the most common site of oral cancer. Any reconstruction of the lips must include both functional and cosmetic considerations. The lips are necessary for speech, facial expression, and eating. Because of their prominent location on the face, even small abnormalities can be apparent.

<span class="mw-page-title-main">Actinic cheilitis</span> Medical condition

Actinic cheilitis is cheilitis caused by long term sunlight exposure. Essentially it is a burn, and a variant of actinic keratosis which occurs on the lip. It is a premalignant condition, as it can develop into squamous cell carcinoma.

Oral and maxillofacial pathology refers to the diseases of the mouth, jaws and related structures such as salivary glands, temporomandibular joints, facial muscles and perioral skin. The mouth is an important organ with many different functions. It is also prone to a variety of medical and dental disorders.

Inferior alveolar nerve block is a nerve block technique which induces anesthesia (numbness) in the areas of the mouth and face innervated by one of the inferior alveolar nerves which are paired on the left and right side. These areas are the skin and mucous membranes of the lower lip, the skin of the chin, the lower teeth and the labial gingiva of the anterior teeth, all unilaterally to the midline of the side on which the block is administered. However, depending on technique, the long buccal nerve may not be anesthetized by an IANB and therefore an area of buccal gingiva adjacent to the lower posterior teeth will retain normal sensation unless that nerve is anesthetized separately, via a (long) buccal nerve block. The inferior alveolar nerve is a branch of the mandibular nerve, the third division of the trigeminal nerve. This procedure attempts to anaesthetise the inferior alveolar nerve prior to it entering the mandibular foramen on the medial surface of the mandibular ramus.

<span class="mw-page-title-main">Heck's disease</span> Medical condition

Heck's disease, also known as Focal Epithelial Hyperplasia, is an asymptomatic, benign neoplastic condition characterized by multiple white to pinkish papules that occur diffusely in the oral cavity. Can present with slightly pale, smooth or roughened surface morphology. It is caused by the human papilloma virus types 13 and 32. It exhibits surface cells with vacuolated cytoplasm around irregular, pyknotic nuclei and occasional cells with mitosis-like changes within otherwise mature and well-differentiated epithelium. A distinguishing histologic feature is elongated rete ridges with mitosoid bodies. It shows 'cobblestone' appearance clinically. It was first identified in the Aboriginal population of North America.

<span class="mw-page-title-main">Plasma cell gingivitis</span> Medical condition

Plasma cell gingivitis is a rare condition, appearing as generalized erythema (redness) and edema (swelling) of the attached gingiva, occasionally accompanied by cheilitis or glossitis. It is called plasma cell gingivitis where the gingiva (gums) are involved, plasma cell cheilitis, where the lips are involved, and other terms such as plasma cell orifacial mucositis, or plasma cell gingivostomatitis where several sites in the mouth are involved. On the lips, the condition appears as sharply outlined, infiltrated, dark red plaque with a lacquer-like glazing of the surface of the involved oral area.

<span class="mw-page-title-main">Salivary gland disease</span> Medical condition

Salivary gland diseases (SGDs) are multiple and varied in cause. There are three paired major salivary glands in humans: the parotid glands, the submandibular glands, and the sublingual glands. There are also about 800–1,000 minor salivary glands in the mucosa of the mouth. The parotid glands are in front of the ears, one on side, and secrete mostly serous saliva, via the parotid ducts, into the mouth, usually opening roughly opposite the second upper molars. The submandibular gland is medial to the angle of the mandible, and it drains its mixture of serous and mucous saliva via the submandibular duct into the mouth, usually opening in a punctum in the floor of mouth. The sublingual gland is below the tongue, on the floor of the mouth; it drains its mostly mucous saliva into the mouth via about 8–20 ducts, which open along the plica sublingualis, a fold of tissue under the tongue.

<span class="mw-page-title-main">Lip licker's dermatitis</span> Medical condition

Lip licker's dermatitis is a type of skin inflammation around the lips due to damage by saliva from repetitive lip licking and is classified as a subtype of irritant contact cheilitis. The resulting scaling, redness, chapping, and crusting makes a well-defined ring around the lips. The rash may extend as far as the tongue can reach and usually does not occur at the corners of the mouth. It commonly occurs during winter months but some people can have it year-round if lip licking is a chronic habit.

References

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  2. 1 2 3 Chiego, Daniel J. (2018). "14. Oral mucosa". Essentials of Oral Histology and Embryology: A Clinical Approach. Elsevier. p. 170. ISBN   9780323569323.
  3. Kobayashi, H; Tagami, H (March 2004). "Functional properties of the surface of the vermilion border of the lips are distinct from those of the facial skin". British Journal of Dermatology. 150 (3): 563–567. doi:10.1046/j.1365-2133.2003.05741.x. PMID   15030342. S2CID   42980307.
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  15. Saucer, Caroline; Torg, Elisabeth (1996). The Female Body: An Owner's Manual : a Head-to-toe Guide to Good Health and Body Care-- at Any Age . Rodale Press. ISBN   9780875964003. lip liner vermilion.
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