D2.34 - Pediatric allergic contact cheilitis associated with propolis sensitization

Background: Chronic cheilitis in children can have multiple causes, including contact allergies. Propolis, used as an additive in certain foods and confectionery, is a rare allergen but can cause persistent lip lesions. The aim of our study was to report a case of allergic contact cheilitis caused by propolis in a child.

Case description: A 7-year-old boy with personal and family history of atopy, and no known food allergies, had chronic cheilitis for two years. Examination revealed perioral dryness, erythema, labial edema, commissural fissures, and desquamation of the lower lip, associated with localized pruritus, without satellite lesions or systemic involvement. Mycological tests were negative, and topical corticosteroids were ineffective. Environmental investigation revealed repeated mouthing of pens and pencils, handling of toys containing resins, and regular consumption of candies and chewing gum, sometimes enriched with hive products. Standard patch testing was positive for propolis, establishing a relevant link between the cheilitis and sensitization to this allergen present in honey-based confectionery.

Conclusions: This case highlights the importance of a detailed environmental and dietary exposure assessment in chronic cheilitis in children. Propolis should be considered a potential allergen, allowing targeted management and effective avoidance of the sensitizing agent.