| Exfoliative cheilitis (EC) is a kind of chronic unspecific inflammation which has a higher incidence than other kinds of diseases affected the vermilion of the lips. The initial investigation done by our hospital indicated that the prevalence of EC in winter was very high in Tibet, which was much higher than prevalence reported in lower altitude areas. Living conditions, environment and climate in Tibet, which is called"roof of the World"because of its high altitude, is apparently different from other areas of China. The characteristics of climate and environment of Tibet is lower humidity, heavy ultraviolet radiation, oxygen deficiency and coldness.This study comprised three sections, including epidemiological study, detection of inflammatory factors in serums and supernatant of saliva, psychological analysis of EC patients. The results were shown as following:1. Epidemiological study of EC among male population in certain areas of China A total to 1355 male adults (including 706 in Lhasa, 270 in Hongkong, 379 in Xi'an) were selected by the cluster sampling method. The survey results showed that the prevalence of exfoliative cheilitis (EC) in Lhasa, Hongkong, and Xi'an was 59.6%, 11.5%, 7.7% respectively. Of all the 1355 male adults, 757 individuals (55.87%) had ever suffered from exfoliative cheilitis (EC), and of the 757 individuals, 658 individuals (86.92%) usually suffered from exfoliative cheilitis(EC) in winter, this disease usually affected lower lip of 237 individuals (31.31%) and both lips of 432 individuals(58.6%). Logistic regression analysis showed that statistical regression relationship was observed between smoking history, labor intensity, amount of water drunk, susceptivity to common cold, outdoor occupation, duration of habitation in the locality and EC, and all regression coefficient were positive.2. Study of certain kinds of inflammation factors in supernatant of saliva and serum of conscripts with EC in Tibet24 patients including 12 patients with slight degree and 12 patients with weighty degree of clinical manifestation of EC were divided to two groups. 8ml venous blood and 5ml saliva was taken from the samples and centrifuged; serum and supernatant of saliva were used to study the difference of IL-1α, IL-4 and TNF-αbetween two groups. The survey results showed that there is no statistical difference between two groups, but all the average content of the three kinds of cytokine was significant higher than healthy samples in lower altitude areas. Results showed in table 1 and table 2. 3. Psychological analysis of EC patients186 patients were selected by randomized sampling method and asked to fill in one piece of defence style questionnaire and symptom checklist-90. All the samples were divided into 2 groups according to the degree of clinical manifestation of EC. The survey results showed that significant difference of all factors of the two kind of questionnaire can't be observed between the two groups.All of the former results indicated that: the special climate and environment in Tibet, psychological factors may be the risk factors of EC. IL-1α, IL-2, TNF-α may be involved in occurrence and process of EC. We should not only apply medicine in the conscripts, but some psychological guidance should also be carried out to help them overcome tension and anxiety.
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