Clinicopathological profile and management of 161 cases of actinic cheilitis

Abstract

BACKGROUNDActinic cheilitis (AC) is a potentially malignant disorder of the lip caused by chronic exposure to ultraviolet radiation from the sun.OBJECTIVESTo evaluate the clinical, demographic, morphological and therapeutic management in AC cases data associating to the histopathological grading.METHODSDemographic, clinical and management data of 161 patients with AC were analyzed. In biopsied cases, two calibrated examiners performed histopathological grading by binary system.RESULTSThere was a prevalence of males (79.5%), aged 40 years or older (77.5%), light-skinned (85.7%), experiencing occupational exposure to sunlight (80.3%), with AC presenting clinically as white lesions (33.6%). Conservative treatment was adopted in 78 cases and biopsy in 83 cases (60.2% graded as low-risk AC). There were no significant associations between histopathological grading and gender (p= 0.509), age (p=0.416), ethnicity (p=0.388), occupational exposure to sunlight (p=1.000) or clinical presentation (p=0.803).CONCLUSIONThis study reinforces the hypothesis that demographic and clinical characteristics of AC are not related to histopathological grading. Advice on protection from sun exposure should be encouraged to avoid progression of AC and invasive therapies.

Immunoexpression of glucocorticoid receptor alpha (GRα) isoform and apoptotic proteins (Bcl‐2 and Bax) in actinic cheilitis and lower lip squamous cell carcinoma

“…Despite the important role suggested for GRα in malignant neoplasms, to our knowledge, there are no studies investigating this receptor in lip carcinogenesis (PubMed Database, accessed 30/04/2018). Such studies are even much important considering the possible use of corticosteroids for the treatment of AC . Therefore, the objective of this study was to evaluate the immunoexpression of GRα and of apoptosis‐related proteins (Bcl‐2 and Bax) in cases of AC and lower lip SCC (LLSCC) in order to gain much insight into the mechanisms involved in lip carcinogenesis.…”

“…Such studies are even much important considering the possible use of corticosteroids for the treatment of AC. 16 Therefore, the objective of this study was to evaluate the immunoexpression of GRα and of apoptosis-related proteins (Bcl-2 and Bax) in cases of AC and lower lip SCC (LLSCC) in order to gain much insight into the mechanisms involved in lip carcinogenesis.…”

“…Within this context, little is known about the expression of GRα in AC and LLSCCs. These facts, together with the possible use of corticosteroids for the treatment of AC16 and the important impact of lymph node metastases on the prognosis of LLSCCs, 24 highlight the need to investigate the possible participation of GRα in lip carcinogenesis. In our study, expression of GRα was observed in all AC and LLSCC cases, with high median percentages of positivity.…”

Use of lip photoprotection in patients suffering from actinic cheilitis

“…Moreover, the lip has been considered a high-risk location for SCC. Adequate photoprotection should be the first and most important measure to prevent AC [5][6][7][8][9][10]. Little attention has been paid in the past to sun protection habits focused on the lips and only few studies have investigated this issue.…”

Management of actinic keratosis at specific body sites in patients at high risk of carcinoma lesions: expert consensus from the AKTeam™ of expert clinicians

“…16 Its prevalence is high in light-skinned males, in those aged ≥40 years, and in individuals with occupational exposure to sunlight. 17 Treatment options for AC include topical therapy or surgical interventions, although due to a lack of comparative studies, there is little consensus regarding optimal treatment. Newer treatment options include ingenol mebutate, methyl 5-aminolevulinate (MAL)-or 5-aminolevulinic acid (ALA)-PDT, erbium: yttrium-aluminium (Er:YAG) ablative fractional laser (AFL)-assisted MAL-PDT or erbium laser resurfacing ( Table 2).…”