What is actinic cheilitis?
Actinic cheilitis or cheilosis is a term used to describe benign or pre-malignant changes on the lip due to chronic sun exposure. It is also often called solar cheilitis, and sometimes, actinic cheilitis with histological atypia.
cheilitis means an inflammatory condition of the lips. Actinic cheilitis affects the vermilion, i.e. the red part of the lip.
What are the symptoms of actinic cheilitis?
Actinic cheilitis most commonly results in the following features:
- Dry lips
- Thinned skin of the lips
- Scaly patches
Less common features of actinic cheilitis include:
- Swelling of the lip
- Redness and soreness
- Ulceration and crusting
- Loss of demarcation between the vermilion border of the lip and its adjacent skin
- Prominent folds and lip lines
- White thickened patches (leukokeratosis)
- Discoloured skin with pale or yellow areas
Invasive squamous cell carcinoma should be suspected if a persistent ulcer or lump develops.
What is the cause of actinic cheilitis?
Actinic cheilitis is due to damage to cellular DNA by chronic sun exposure. Smoking may contribute; cheilitis tends to be more severe in smokers.
What investigations should be done?
The pathologist may report premalignant changes in the cells of the epidermis (outer layer of the skin) and sun-related changes such as solar elastosis in the underlying dermis (connective tissue layer).
Treatment options include:
- 5-fluorouracil cream
- Imiquimod cream
- Topical retinoids
- Photodynamic therapy
- Vermilionectomy (surgical removal of the lip)
- Laser ablation e.g. with Er:YAG laser
Limiting sun exposure, wearing a hat with a good brim, and using a lip balm containg sunscreen are recommended. Men can consider growing a moustache. Smoking should be stopped.
- Cavalcante AS, Anbinder AL, Carvalho YR. Actinic cheilitis: clinical and histological features. J Oral Maxillofac Surg. 2008 Mar;66(3):498-503. Medline.
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