Usefulness of tissue autofluorescence imaging in actinic cheilitis diagnosis

Abstract

Actinic cheilitis (AC) is a potentially malignant disorder of the lips. Because of its heterogeneous clinical aspect, it is difficult to indicate representative biopsy area. The purpose of this study was to evaluate the usefulness of tissue autofluorescence in AC diagnosis. The system was composed of a 405-nm light-emitting diode, sent to the sample by a dichroic, that allows the fluorescence signal to reach a camera directly plugged in the system. Fifty-seven patients with clinical diagnosis of AC and 45 normal volunteers were selected. According to clinical and fluorescence features, one or more areas were selected for biopsies in the AC group and epithelial dysplasia (ED) grades were established. The autofluorescence images were processed by a clustering algorithm for AC automated diagnosis. The tissue autofluorescence image revealed a heterogeneous pattern of loss and increase of fluorescence in patients with AC. ED was found in 93% of the cases, and most of the areas graded as moderate or severe ED were chosen with the aid of autofluorescence. The processed autofluorescence images from AC patients showed a higher number of spots in an irregular pattern. Tissue autofluorescence image system is a useful technique in association with clinical examination for AC diagnosis.

A comparative study using WHO and binary oral epithelial dysplasia grading systems in actinic cheilitis

“…This study was carried out with the approval of the Research Ethics Committee (0073.0.258,000‐11, May 6, 2011, Universidade Federal Fluminense, Brazil) and in accordance with the Declaration of Helsinki. Lower lip biopsies from 107 cases of AC were retrieved from Universidade Federal Fluminense (Nova Friburgo, Rio de Janeiro, Brazil), part of the same database included in a previous study (Takahama Junior et al , ). The sample was composed of 60 male (56.1%) and 47 female (43.9%) with ages ranging from 21 to 86 years (mean of 59 years).…”

“…Microscopic features of AC may include different degrees of keratinization, hyperplasia or atrophy of the epithelium, and solar elastosis, a chronic inflammatory infiltrate, and dilated blood vessels in the connective tissue (Cavalcante et al , ; Wood et al , ). Epithelial dysplasia (ED) may not always be present (de Santana Sarmento et al , ), but some studies identified this feature in 100% of AC (Markopoulos et al , ; Cavalcante et al , ; Takahama Junior et al , ). In addition, since ED is described as the microscopic features that confers the malignant potential to AC (Hsue et al , ), there is a study that included ED as a criteria for AC diagnosis (Kaugars et al , ).…”

Widefield fluorescence imaging as an auxiliary tool to select the biopsy site for actinic cheilitis diagnosis

“…The AC lip presents a more heterogenous fluorescence when compared to the normal lip [19]. This characteristic is due to the diffuse and also heterogenous AC lesion.…”

Evaluation of vermillion border descriptors and relevance vector machines discrimination model for making probabilistic predictions of solar cheilosis on digital lip photographs

“…Thus development of objective measures that would assist appropriate patient selection who need treatment is pivotal for improving healthcare in this subset of patients. Currently the evaluation of SC severity is primarily subjective based on clinical criteria as are alterations of the configuration of lower lip vermillion-skin border [4,10] and variations of color, consistency or keratinization of the lower lip surface as well as relapsing fissuring. Histopathological evaluation offers insight of the presence and severity of the condition at tissue, yet, as SC involves the entire lower lip at various degrees of severity, it is only representative of the biopsy site [5,11].…”