Diclofenac in hyaluronic acid gel: an alternative treatment for actinic cheilitis

Abstract

ObjectiveActinic cheilitis (AC) is a precancerous lesion of the lip vermillion caused by prolonged exposure to ultraviolet light. The aim of this study was to evaluate the effect of 3% diclofenac in 2.5% hyaluronic acid gel in the treatment of AC.MethodsThirty-four patients with chronic AC were treated twice a day with topical diclofenac during a period of 30 to 180 days. The individuals were followed up every 15 days by means of clinical examination and digital photographic documentation.ResultsOf the 27 patients that completed the study, 12 (44%) showed complete remission of the whitish plaques and exfoliative areas, and 15 (56%) had partial remission of the clinical picture of cheilitis. The latter group was submitted to excision of the leukoplakic areas which diagnosis varied from mild to moderate epithelial dysplasia.ConclusionThe results suggest a promising role for diclofenac in hyaluronic acid gel in the treatment of AC. This treatment has the advantages of not being invasive and showing few side effects.

Actinic cheilitis: clinicopathologic profile and association with degree of dysplasia

“…Patients can develop the disease at any age, but peak prevalence is observed between the fourth and fifth decades of life and mean ages range from 50.6 years to 64.3 years. The disease is most common in people of White European ethnicity . The characteristics of the present sample in relation to gender, age, and race agree with those reported in the literature; statistically significant relationships were observed for these variables, including occupational exposure to sunlight.…”

“…This multifocal nature, observed both clinically and microscopically, makes it difficult to correlate clinical findings with histologic findings. Such a correlation might be possible in a series with a greater number of patients or by taking multiple biopsy specimens from the same patient, but the latter approach raises ethical issues …”

Actinic cheilitis: a case report and a review of the literature

“…Considering the symptoms presented, we decided to prescribe the topical antiinflammatory drug triamcinolone acetonide in emollient base for dental use, three times a day for 15 days, showing excellent response. Positive clinical success with the use of anti-inflammatory for the treatment of actinic cheilitis is reported in the literature by various authors [14,15,21,22]. The use of the non-steroidal anti-inflammatory drug diclofenac in the treatment and prevention of the malignization of actinic cheilitis is explained by the authors for its possible anticancer effect on inhibiting cyclooxygenase (COX-1 and COX-2) [23].…”

Vermilionectomy for a Progressively Actinic Cheilitis: Case Report

“…Although there is no AC protocol treatment, some authors have sought alternative treatments, such as Lima et al, who reported the promising use of diclofenac in hyaluronic acid gel, which is a noninvasive treatment with minimal side effects [9]. Diclofenac, a nonsteroidal anti-inflammatory drug, decreases proliferative cell cycle dynamics by inhibiting prostaglandin formation.…”