Since the doctors did not know the cause of EC, they wrote case history including what the patients had in common is that they worked outside. But it is not uncommon to work outside in El Salvador. When I had a mole removed, the doctor asked me if I spent lots of time in the sun. Many people do, but I do not. So, the biopsy report read that patient denied sun exposure, but sun exposure was detected in mole. I guess I had more sun exposure as a child than I do now.
I just want to clarify that the patients did not receive hydrocortisone injections. They only received hyaluronidase injections, which were used to help hydrocortisone ointment and 1% neomycin absorb better. Having the ointment custom made so it only contains neomycin instead of extra ingredients Neosporin has makes a difference, too.
Someone replied that a dermatologist said the hyaluronidase turns off fibroblasts. I believe fibroblasts are causing the inflammation in my lips. I would prefer to only have hyaluronidase injections without use of ointment for a month.