Actinic cheilitis

Synonyms

Actinic cheilosis

Overview

Actinic cheilitis is abbreviated to AC and it is also termed as actinic cheilosis, actinic keratosis of lip, solar cheilosis, sailor's lip, farmer's lip, cheilitis (lip inflammation). It is caused by long term sunlight exposure. Essentially it is a burn and a variant of actinic keratosis, which occurs on the lip. It is a premalignant condition, as it can develop into squamous cell carcinoma (a type of mouth cancer).

Symptoms

  • Dry lips (dry sensation)
  • Cracked lips
  • Scaly lips
  • Pale lips
  • White lips
  • Scaly bump on lip
  • Crusty bump on lip
  • Red lip
  • Discolored lip
  • Lip ulcers

Causes

Actinic cheilitis is caused by chronic and excessive exposure to ultraviolet radiation in sunlight.

Risk factors include:

Outdoor lifestyle: e.g. farmers, sailors, fishermen, windsurfers, mountaineers, golfers, etc. This has given rise to synonyms for this condition such as "sailor's lip" and "farmer's lip". The prevalence in agricultural workers in a semi-arid region of Brazil is reported to be 16.7%.

Light skin complexion: the condition typically affects individuals with lighter skin tones, particularly Caucasians living in tropical regions. In one report, 96% of persons with AC had phenotype II according to the Fitzpatrick scale.

Age: Gender: typically affects older individuals, and rarely those under the age of 45.

Gender: the condition affects males more commonly than females. Sometimes this ratio is reported as high as 10:1.

Additional factors may also play a role, including tobacco use, lip irritation, poor oral hygiene, and ill-fitting dentures.

Prevention

To prevent Actinic cheilitis from developing, protective measures could be undertaken such as

  • Avoiding mid-day sun
  • Use of a broad-brimmed hat
  • Lip balm with anti UVA
  • UVB ingredients (e.g. para-aminobenzoic acid)
  • Sun blocking agents (e.g. zinc oxide, titanium oxide) prior to sun exposure

Diagnosis

Tissue biopsy is indicated.

Treatment

This condition is considered premalignant because it may lead to squamous cell carcinoma in about 10% of all cases. It is not possible to predict which cases will progress into SCC, so the current consensus is that all lesions should be treated.

Treatment options include 5-fluorouracil, imiquimod, scalpel vermillionectomy, chemical peel, electrosurgery, and carbon dioxide laser vaporization. These curative treatments attempt to destroy or remove the damaged epithelium.

All methods are associated with some degree of pain, edema, and a relatively low rate of recurrence.

Resources

  • NIH