Actinic Cheilitis: Clinical Characteristics Observed in 75 Patients and a Summary of the Literature of This Often Neglected Premalignant Disorder

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.

Share and Cite:

Oliveira Miranda, A. , Miranda Ferrari, T. , Leite, T. , Cunha, K. and Dias, E. (2014) Actinic Cheilitis: Clinical Characteristics Observed in 75 Patients and a Summary of the Literature of This Often Neglected Premalignant Disorder. International Journal of Clinical Medicine, 5, 1337-1344. doi: 10.4236/ijcm.2014.521171.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Cavalcante, A.S.R., Anbinder, A.L. and Carvalho, Y.R. (2008) Actinic Cheilitis: Clinical and Histological Features. Journal of Oral and Maxillofacial Surgery, 66, 498-503.
http://dx.doi.org/10.1016/j.joms.2006.09.016
[2] Markopoulos, A., Albanidou-Farmaki, E. and Kayavis, I. (2004) Actinic Cheilitis: Clinical and Pathologic Characteristics in 65 Cases. Oral Diseases, 10, 212-216.
http://dx.doi.org/10.1111/j.1601-0825.2004.01004.x
[3] da Silva, F.D., Daniel, F.I., Grando, L.J., Calvo, M.C., da Silva Rath, I.B. and Fabro, S.M.L. (2006) Estudo da prevalência de alterações labiais em pescadores da ilha de Santa Catarina; Prevalence of lipspathologies in fishermen of Santa Catarina Island. Revista Odonto Ciência, 21, 37-42.
[4] da Costa Fontes, K.B.F., Cunha, K.S.G., Rodrigues, F.R., da Silva, L.E., Dias, E.P., et al. (2013) Concordance between Cytopathology and Incisional Biopsy in the Diagnosis of Oral Squamous Cell Carcinoma. Brazilian Oral Research, 27, 122-127.
[5] Calandro, T.L.L., Conde, D.C., Campos, I.T. and Dias, E.P. (2006) A utilização da videoroscopia na investigação de lesões orais; the use ofvideoroscopy for the oral lesionsinvestigation. Revista Brasileira de Odontologia, 66, 170-176.
[6] Conde, D.C., Calandro, T.L.L., Campos, I.T. and Dias, E.P. (2010) The Intraoral Video Camera: A Diagnostic Tool in the Exam of Patient with Increased Oral Cancer Risk. Revista de Clínica e Pesquisa Odontológica, 6, 49-55.
[7] Ulrich, M., González, S., Lange-Asschenfeldt, B., Roewert-Huber, J., Sterry, W., Stockfleth, E., et al. (2011) Non-Invasive Diagnosis and Monitoring of Actinic Cheilitis with Reflectance Confocal Microscopy. Journal of the European Academy of Dermatology and Venereology, 25, 276-284.
http://dx.doi.org/10.1111/j.1468-3083.2010.03777.x
[8] Takahama Junior, A., Kurachi, C., Cosci, A., Pereira Faustino, I.S., Camisasca, D.R., da Costa Fontes, K.B.F., et al. (2013) Usefulness of Tissue Autofluorescence Imaging in Actinic Cheilitis Diagnosis. Journal of Biomedical Optics, 18, Article ID: 76023.
http://dx.doi.org/10.1117/1.JBO.18.7.076023
[9] Williams, P.M., Poh, C.F., Hovan, A.J.S. and Rosin, M.P. (2008) Evaluation of a Suspicious Oral Mucosal Lesion. Journal of the Canadian Dental Association, 74, 275-280.
[10] Freitas, M.C.A., Ramalho, L.M.P., Xavier, F.C.A., Moreira, A.L.G. and Reis, S.R.A. (2008) p53 and MDM2 Protein Expression in Actinic Cheilitis. Journal of Applied Oral Science, 16, 414-419.
http://dx.doi.org/10.1590/S1678-77572008000600011
[11] Martínez, A., Brethauer, U., Borlando, J., Spencer, M.L. and Rojas, I.G. (2008) Epithelial Expression of p53, mdm-2 and p21 in Normal Lip and Actinic Cheilitis. Oral Oncology, 44, 878-883.
http://dx.doi.org/10.1016/j.oraloncology.2007.11.008
[12] Martínez, A., Brethauer, U., Rojas, I.G., Spencer, M., Mucientes, F., Borlando, J., et al. (2005) Expression of Apoptotic and Cell Proliferation Regulatory Proteins in Actinic Cheilitis. Journal of Oral Pathology & Medicine, 34, 257-262.
http://dx.doi.org/10.1111/j.1600-0714.2004.00299.x
[13] Souza, L.R., Fonseca-Silva, T., Pereira, C.S., Santos, E.P., Lima, L.C., Carvalho, H.A., et al. (2011) Immunohisto-chemical Analysis of p53, APE1, hMSH2 and ERCC1 Proteins in Actinic Cheilitis and Lip Squamous Cell Carcinoma. Histopathology, 58, 352-360.
http://dx.doi.org/10.1111/j.1365-2559.2011.03756.x
[14] Xavier, F.C.A., Takiya, C.M., Reis, S.R.A. and Ramalho, L.M.P. (2009) p63 Immunoexpression in Lip Carcinogenesis. Journal of Molecular Histology, 40, 131-137.
http://dx.doi.org/10.1007/s10735-009-9223-4
[15] Sarmento, D.J.S., Almeida, W.L., Miguel, M.C.C., Queiroz, L.M.G., Godoy, G.P., Cruz, M.C.F.N., et al. (2013) Immunohistochemical Analysis of Mismatch Proteins in Carcinogenesis of the Lower Lip. Histopathology, 63, 371-377.
http://dx.doi.org/10.1111/his.12197
[16] Freitas, V.S., Andrade, S.P.P., Freitas, R.A., Pinto, L.P. and Souza, L.B. (2011) Mast Cells and Matrix Metalloproteinase 9 Expression in Actinic Cheilitis and Lip Squamous Cell Carcinoma. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics, 112, 342-348.
http://dx.doi.org/10.1016/j.tripleo.2011.02.032
[17] Souza, L.R., Fonseca-Silva, T., Santos, C.C.O., Oliveira, M.V.M., Corrêa-Oliveira, R., Guimarães, A.L.S., et al. (2010) Association of Mast Cell, Eosinophil Leucocyte and Microvessel Densities in Actinic Cheilitis and Lip Squamous Cell Carcinoma. Histopathology, 57, 796-805.
http://dx.doi.org/10.1111/j.1365-2559.2010.03721.x
[18] Huber, M. and Terezhalmy, G. (2006) The Patient with Actinic Cheilosis. General Dentistry, 54, 274-282.
[19] Shah, A.Y., Doherty, S.D. and Rosen, T. (2010) Actinic Cheilitis: A Treatment Review. International Journal of Dermatology, 49, 1225-1234.
http://dx.doi.org/10.1111/j.1365-4632.2010.04580.x
[20] Ghasri, P., Adman, I.S., Petelin, A. and Zachary, C.B. (2012) Treatment of Actinic Cheilitis Using a 1,927-nm Thulium Fractional Laser. Dermatologic Surgery, 38, 504-507.
http://dx.doi.org/10.1111/j.1524-4725.2011.02262.x
[21] Kornevs, E., Skagers, A., Tars, J., Bigestans, A., Lauskis, G. and Libermanis, O. (2005) 5 Year Experience with Lower Lip Cancer. Stomatologija, Baltic Dental and Maxillofacial Journal, 7, 95-98.
[22] Wood, N.H., Khammissa, R., Meyerov, R., Lemmer, J. and Feller, L. (2011) Actinic Cheilitis: A Case Report and a Review of the Literature. European Journal of Dentistry, 5, 101-106.
[23] Vieira, R.A., Minicucci, E.M., Marques, M.E. and Marques, S.A. (2012) Actinic Cheilitis and Squamous Cell Carcinoma of the Lip: Clinical, Histopathological and Immunogenetic Aspects. Anais Brasileiros de Dermatologia, 87, 105-114.
[24] Corso, F.M., Wilde, C., Gouveia, L.O. and Ribas, M.O. (2006) Queilite Actínica: Prevalência na Clínica Estomatológica da PUCPR. Clin. Pesq. Odontol., 2, 277-281.
[25] Miranda, A.M.O., Soares, L.G., Ferrari, T.M., Silva, D.G., Falabella, M.E.V. and Tinoco, E.M.B. (2012) Prevalence of Actinic Cheilitis in a Population of Agricultural Sugarcane Workers. Acta Odontológica Latinoamericana, 25, 201-206.
[26] Ochsenius, G., Ormeño, A., Godoy, L. and Rojas, R. (2003) A Retrospective Study of 232 Cases of Lip Cancer and Pre Cancer in Chilean Patients. Clinical-Histological Correlation. Revista Médica de Chile, 131, 60-66.
[27] Cataldo, E. and Doku, H.C. (1981) Solar Cheilitis. Journal of Dermatologic Surgery and Oncology, 7, 989-995.
http://dx.doi.org/10.1111/j.1524-4725.1981.tb00203.x
[28] Andrade, E.S.S., Sobral, A.P.V., Laureano Filho, J.R., Santos, M.E.S.M. and Camargo, I.B. (2009) Cheilitis Glandularis and Actinic Cheilitis: Differential Diagnoses—Report of Three Unusual Cases. Dermatology Online Journal, 15, 5.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.