Treatment of exfoliative cheilitis with Traditional Chinese Medicine: a systematic review.

OBJECTIVE: To systematically review treatments of exfoliative cheilitis based on symptom patterns in terms of Traditional Chinese Medicine.

METHODS: PubMed, Cochrane Central Register of Controlled Trials and Wanfang data were screened for case reports, case series or clinical trials that were published in English or Chinese from January, 1973 to September, 2015. The keyword of "exfoliative cheilitis or scaling cheilitis or factitious cheilitis" was used. Effectiveness or ineffectiveness was investigated as outcome for Meta analysis, which is based on effective index in each study. Response to treatment was described for case reports or case series.

RESULTS: From 38 screened studies, 17 were randomized controlled trials (RCTs), 5 were single-arm trials, and 16 were case reports or case series. Three RCTs were eligible for Meta analysis and all of them compared managements between Traditional Chinese Medicine and corticosteroids for exfoliative cheilitis, which involved 223 participants. Interestingly, data of Meta analysis showed similar effect of Traditional Chinese Medicine and corticosteroids for patients with exfoliative cheilitis [relative risk ratio: 1.10; 95% CI (1.00-1.21), P = 0.06].

CONCLUSION: Traditional Chinese Medicine might be a substitute for corticosteroids on exfoliative cheilitis. However, the evidence and recommendation of exfoliative cheilitis managements need to be taken with caution because of the low quality of evidence in the studies obtained.