Finally, after going somewhat in circles, I had to go to a specialist to understand, lips and their connection to vitiligo. Below find what I could drum up:
1. First the derm said, he knows a lot about Lip. Just like other immune diseases, he does not fully undertand Vitiligo as well.
2. Lip has 2 regions: Mucosal and Cutaneous. Mucocutaneious junction means, where the softer skin meets the relatively rougher skin.....(that line for my child appears to be recedeing, if you can imagine what I mean).
3. Musocal area is the inside area of lip, source of saliva stuff. Muscal area does NOT have melaocytes.
4. Cutaneous is the skin portion (bottom portion in bottom lip towards chin, where you can see vertical lines. Similarly, upper outer portion for the upperlip, towards nose). Cutaneous portion has melanocytes.
5. Hence, Vitiligo does NOT occur on mucosal portion of lip. This Derm has NOT seen even one single case of vitiligo on the mucosal portion in his 21 years of active practice.
6. Vitiligo can show up in the cutaneous portion only.
7. He clearly said, lip redness/pinkness is non-vitiligo. Palish, whitish can be either hypopigmentation or Vitiligo.
8. He also said the same thing about the private parts of both men and women and explained. (somewhat very similar to steps 1 thru 6 described above).
He then said, lip reddening can happen due to 10 different reasons and listed many (I forgot several already). Few I can remember are: injuries and side effects of medications, sleeping happbits, thumb sucking, or misalignment of teeth etc.
He also said, my child's lips are natually reddish/pinkish in general. Basically, nothing to worry from Vitiligo perspective. And, gave some free samples of moisturizers.
he also went on explaining more and more.....Lips are red because there are many blood vessels around the lip area. Skin is very thin in the top and bottom lips. The color of these blood vessels is seen through to the surface of the lips, which makes them appear red. This also kind of explains why lips turn little bluish In winder, cold air makes the blood vessels in the lip region tightens and contracts. Which forces the blood to go deeper into your body.
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