Exodontia.Info
Actinic Cheilitis /
Actinic Keratosis of Lip /
Solar Keratosis / Solar Cheilosis
Actinic Cheilitis (Sailor’s lip; Solar Cheilitis, Actinic
Keratosis of Lip
, Solar Keratosis & Solar Cheilosis)

Definition

Actinic cheilitis is a chronic degenerative disorder of the
lower lip (with sparing of the
commissures).  This is a type
of
actinic keratosis which classically occurs on the lower lip
and is directly related to long-term sun exposure.


Ætiology

Long-term exposure to sunlight.


Clinical Features

In the early stage, mild erythema (reddening) and œdema
(swelling) followed by dryness and fine scaling of the lower
lip
vermilion border (the junction between the lip and skin)
are the presenting signs.

As the lesion progresses, the
epithelium (skin) becomes
thin and smooth, with small whitish-gray areas intermingled
with red regions and scaly formations.  
Erosions (ulcers)
and tiny nodules may develop.

The
vermilion appears atrophic (thinned) and pale with a
glossy surface and loss of demarcation at the
vermilion
border
.  With progression, fissuring and ulceration can
occur along with crusting or scaling.  
Epithelial atrophy and
elastosis are seen histologically and these changes are
irreversible.  Areas of persistent
ulceration should be
biopsied due to a 6 – 10% rate of
malignant
transformation
.

The lesion is
pre-malignant and usually occurs in fair-
skinned men over 50 years of age, 4 – 8th decade of life
and who have had outdoor jobs / activities.


Laboratory Tests

Histo-pathological examination.


Differential Diagnosis

The following conditions should be considered before
making a diagnosis of
actinic cheilitis:



Treatment

Protection of lips from sunlight.  Vermilionectomy in severe
cases.  Treatment of malignancy is primarily surgical;
however, a trial of
topical chemotherapy with 5-
fluorouracil can be used with early lesions.

Prophylactic
laser ablation or vermillionectomy may be
performed in cases where
malignant transformation has
not yet occurred.

Close long-term follow-up is indicated, as these patients
are at risk for additional cancers associated with solar
damage.
Websites & Article:

New Zealand Dermatological Society (DermNZ)

Wikipedia

Bond's Book of Oral Diseases, 4th Edition

Australian Dental Journal


BJOMS 2010.  Treatment of actinic cheilitis with imiquimod 5% & a retractor on the
lower lip - clinical & histological outcomes in 5 patients
Last Updated 2nd December 2012