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actinic cheilitis; solar cheilitis
Etiology: sun exposure (generally chronic)
Pathology: precancerous condition
Epidemiology: (risk factors)
1) fair complexion
2) pipe smoking
Clinical manifestations:
1) chronic erythema & recurrent scaling of the lower lip [2]
2) general lip manifestations [1]
- dry lips
- scaling
- crusting
- gray-white discoloration with atrophic appearance
- vermilion may become indistinct
- late lesions may become elevated & ulcerated
- induration & ulceration suggest possible malignant transformation
3) infection
- pustules suggests Staphylococcus aureus
- vesicles suggest viral etiology
- erythema & scaling suggest Candida
* images [3]
Laboratory:
- lip biopsy required for diagnosis [1]
Complications:
- development of a nodule or ulcer suggests SCCS*
* squamous cell carcinoma skin
Management:
- imiquimod
- topical 5-flourouracil
- cyrotherapy
- laser therapy
- photodynamic therapy [2]
General
cheilitis
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 63-65
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18.
American College of Physicians, Philadelphia 2015, 2018.
- DermNet NZ. Actinic cheilitis (images)
http://www.dermnetnz.org/site-age-specific/solar-cheilitis.html