Abstract
Actinic cheilitis can progress to squamous cell carcinoma in 20% of cases. The purpose of this study was to identify the clinical characteristics of 75 patients with actinic cheilitis and to summarise the current literature concerning actinic cheilitis. A total of 75 patients were evaluated over a 3-year period. The medical history, physical examination results and images were collected from each patient. Demographic data were collected and analysed. To review the literature, the relevant data were collected from scientific journals in the last 30 years. The mean age of the patients was 56 years old; 42 patients (56%) were female, and 66 patients (88%) were white. Nineteen (25.3%) patients reported at least one symptom, including pain, burning and itching. Sixty-five (86.7%) patients presented actinic cheilitis only in the lower lip. All of the patients reported sun exposure, and 44 (58.6%) patients were exposed for more than 10 years. The main clinical aspects investigated and analysed included dryness (100%), flaking (72%) and white lesions (57.3%). Lip assessment is extremely important in medical and dental care. From the 15 lesions assessed in the presence of actinic cheilitis, the most common clinical characteristics observed were dryness, flaking and white lesions. It is imperative to know the clinical aspects that may be encountered in actinic cheilitis in order to achieve early diagnosis, thus avoiding lip squamous cell carcinoma transformation.
Highlights
Cheilitis refers to an inflammatory process of the lips that has many causes
Most authors agree that actinic cheilitis (AC) it is a potentially malignant disorder or an incipient form of carcinoma that may develop into squamous cell carcinoma (SCC) of the lips [1]-[3]
The clinical investigation revealed as the following common clinical observations: dryness (100%), flaking (72%), white lesions (57%) and diffuse blurring between the border of the lip and the skin (55%) (Table 2)
Summary
Cheilitis refers to an inflammatory process of the lips that has many causes. Among the different types of cheilitis, actinic cheilitis (AC) is the most frequent and important and is caused by solar radiation. In addition to clinical exams, cytopathology may contribute to the identification of epithelial dysplasia [4]. Another auxiliary method of diagnosis is the videoroscopic exam, similar to dermatoscopy, which is noninvasive, allowing the in vivo evaluation of the structures of epidermis that are invisible to the naked eye [5] [6]. To establish the histopathological diagnosis of AC, some morphological parameters must be considered, including acanthosis, thicker keratin layer [parakeratosis or orthokeratosis], solar elastosis [the most consistent histological finding], the presence of inflammatory infiltration and perivascular inflammation. Many studies have been conducted with the purpose of identifying prognostic markers that identify lesions with a greater potential for malignant transformation. Fibroblast and mast cell densities have been studied, suggesting that these cells may contribute to the tumour progression in its invasion front [16] [17]
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