II. Epidemiology

  1. Prevalence 10 to 40% in high risk occupational exposures (e.g. fishermen, farmers)

III. Pathophysiology

  1. Premalignant lip lesion associated with chronic UV radiation exposure
  2. Lower lip more often affected

IV. Risk Factors

  1. Light skin tones
  2. Outdoor work >25 years
  3. Age >60 years old
  4. History of Nonmelanoma Skin Cancer
  5. Genetic Syndromes with increased sun susceptibility (younger age at presentation)
    1. Xeroderma pigmentosum
    2. Oculocutaneous Albinism

V. Signs

  1. Early Changes
    1. Persistent dry, Scaling lips
    2. Sandpaper feel to involved lip
    3. Mild lip atrophy
  2. Later, More Advanced Changes
    1. Lip atrophy
    2. Vermillion border with blurred margin
    3. Localized Edema or erythema
    4. Hyperkeratotic Plaques
    5. Ulceration
    6. Crusting

VI. Labs: Biopsy Indications

  1. Avoid biopsy in early, mild to moderate typical Actinic Cheilitis
  2. Biopsy lesions suspicious for Squamous Cell Carcinoma
    1. Hyperkeratotic or Nodular areas of the lip with or without erosions or ulcerations

VII. Complications

VIII. Management

  1. Refer if suspicion for lip Squamous Cell Carcinoma
  2. Topical Treatments used for Actinic Cheilitis or Squamous Cell Carcinoma In Situ
    1. Fluorouracil
    2. Cryotherapy (Liquid Nitrogen)
    3. Curettage
    4. Dermabrasion
    5. Imiquimod

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Related Studies

Ontology: Actinic cheilitis (C0267026)

Concepts Disease or Syndrome (T047)
MSH C535669
SnomedCT 200839009, 46795000
English actinic cheilitis, actinic cheilitis (diagnosis), Actinic cheilitis, Actinic cheilosis, cheilitis actinic, Solar keratosis of lip, Actinic cheilitis (disorder), cheilitis; actinic, actinic; cheilitis
Czech Aktinická cheilitida
Dutch actinische cheilitis, actinisch; cheilitis, cheilitis; actinisch
French Chéilite actinique
German aktinische Cheilitis
Hungarian Actinicus cheilitis
Italian Cheilite attinica
Japanese 光線性口唇炎, コウセンセイコウシンエン
Portuguese Queilite actínica
Spanish Queilitis actínica, queilitis actínica (trastorno), queilitis actínica, queratosis solar del labio