David Picascia. 44. Cheilitis can also be a symptom of a contact reaction to an irritant or allergen, or may be provoked by sun exposure (actinic cheilitis) or drug intake, especially retinoids. This paper. J Am Acad Dermatol. As with actinic keratoses, it is widely accepted that this lesion is due to excessive sun exposure. Actinic cheilitis is a condition where the outer layer of the lips becomes damaged. Although cheilitis as a term describing lip inflammation has been identified and recognized for a long time, until now there have been no clear recommendations for its work-up and classification. [ 3 ] Cutaneous horn: hypertrophic conical-shaped protuberance growing from the surface of the skin; underlying AKs in 19% to 37%. We emphasized the clinical management, diagnosis criteria and treatment, taking into consideration that GC is a rare condition and makes a differential diagnosis with other entities that may occur on lips. Actinic prurigo • Familial photodermatitis, Seen in High altitude especially in Latin America, and in China. It usually appears as very chapped lips, then may turn white or scaly. Actinic Cheilitis . The pathological features of actinic cheilitis are variable thickening or atrophy of the lip, partial thickness epidermal dysplasia , … cystadenoma, Search SpringerLink. Search. An appropriate history can help elicit the proper diagnosis, such as inquiring about new medications or lip balms, lip-licking habits, and cumulative sun exposure. Key differences identified between actinic keratosis and cutaneous squamous cell carcinoma by transcriptome profiling. Aldehyde dehydrogenase 1 expression in basal cell carcinoma, actinic keratosis and Bowen's disease. Actinic keratosis (AK) lesions are skin-coloured, yellowish, or erythematous, ill-defined, irregularly shaped, small, scaly macules or plaques localised in sun-exposed areas of the body. 17. Actinic cheilitis is the counterpart of actinic keratosis of the skin and can also develop into squamous cell carcinoma. 2004 Edition | Editors: N. Levine, C. C. Levine. Actinie cheilitis: A review of the etiology, differential diagnosis, and treatment. It is a pre-cancerous condition squamous cell carcinoma of the lip) that most commonly occurs in light-skinned individuals, and in people who live in hot, dry climates and/or work outdoors, like construction workers. Home; Log in; Dermatology Therapy. Share. Actinic cheilitis: scaly red roughness with induration, fissuring, and ulceration of the lower lip to the commissures. Journal of the American Academy of Dermatology, 1987. Medicines and therapies. Skin biopsy is the golden standard regarding the evaluation of a persistent suspicious lesion on the lip. The differential diagnosis of exfoliative cheilitis include: • Atopy • Candida yeast infection • Hypervitaminosis A • Actinic cheilitis • Cheilitisglandularis • Contact dermatitis • Photosensitivity. Actinic cheilitis (AC) is a lip inflammation caused by long-term sunlight exposure. Chicago, IL With today's increase in sun worshippers, the number of sun-induced skin lesions is increasing. Skin biopsy is the golden standard regarding the evaluation of a persistent suspicious lesion on the lip. 1987. pp. “Actinic cheilitis:a review of the etiology, differential diagnosis, and treatment”. 6 th ed, pp. A short summary of this paper. Clinical Information and Differential Diagnosis of Cheilitis, Actinic References. In this article we review the etiology, clinical spectrum, histology, differential diagnosis, and treatment of actinic cheilitis. vol. Actinic cheilitis is also called solar cheilitis because it is caused by long-term sun exposure. Cutaneous squamous cell carcinoma . In this article we report the case of a male patient, leucoderma, 48 years old, that exhibited actinic cheilitis and glandular cheilitis. 721-725, 741. ↑ Busam, Klaus J. The patient may complain of prurigo, burning sensation and tenderness of affected area and eczema in other parts of the body, depending on the source and manifestation of allergy aiding differential diagnosis. What is the dermoscopic differential diagnosis of actinic keratosis? Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Actinic cheilitis - the same lesion on the lip. Objective: describe two clinical cases of exfoliative cheilitis, focusing on the differential diagnosis. It may coexist with solar lentigo, cutaneous squamous cell carcinoma, and lentigo maligna. Actinic cheilitis is cheilitis (lip inflammation) caused by long term sunlight exposure. New York: Mosby, 2003. Differential diagnosis: The clinician should consider squamous cell carcinoma as the primary diagnosis. Saunders. Cheilitis glandularis: As the patient had swollen lips, nodular growth with an everted margin, ulceration; cheilitis glandularis, a chronic inflammatory condition manifesting as a minor salivary gland hypersecretion with ductal ectasia can be considered. The condition is also known as solar keratosis.. Actinic keratoses are ultraviolet (UV) light-induced lesions of the skin, which are by far the most common lesions with malignant potential to arise on the skin. It is significantly more common in men, elderly patients, and fair-skinned patients. Skip to main content Skip to table of contents. Differential diagnosis of exfoliative cheilitis. Differential diagnosis Differential diagnosis may include cheilitis granulomatosa, cutaneous lupus erythematosus (see this term) angioedema, atopic cheilitis, actinic cheilitis, and benign and malignant minor salivary gland tumours (e.g. A skin biopsy may be taken if skin cancer or an inflammatory cause of cheilitis is suspected. Atopy, actinic damage, exfoliative cheilitis, cheilitis granulomatosa or glandularis, contact dermatitis, photosensitivity reactions and neoplasia should be considered in the differential diagnosis of crusted and ulcerated lesions of the lip. 2 Cheilitis granulomatosa: A rare condition manifesting as an episodic, non-tender enlargement of one or both the lips. Freedberg, Irwin M., ed. DIFFERENTIAL DIAGNOSIS OF CHEILITIS – HOW TO CLASSIFY CHEILITIS? Fitzpatrick's Dermatology in General Medicine. (2009). Eczematous cheilitis: Reddish scaly eruptions are present in both lips and perioral skin with edema, fissures, vesicles and superficial ulceration [3]. Actinic cheilitis is a diagnosis made from clinical and histopathology evaluation. Download Full PDF Package . Lumican as a novel marker for differential diagnosis of Bowen disease and actinic keratosis. There is an atopic tendency in 10-20 per cent of patients with cheilitis. June Robinson. Differential Diagnosis of Actinic Keratosis The relatively nonspecific clinical features of AK can make differential diagnosis challenging. ... • Lymphoma is a rare differential diagnosis. The term actinic keratosis (AK) was coined in 1958 and means literally thickened scaly growth (keratosis) caused by sunlight (actinic). diagnosis of glandular cheilitis or actinic cheilitis, a histologically malignant tumour is already present in 18-35 per cent of the cases. June Robinson. PMID 3305604. ... non-actinic cheilitis, reported by O’Gorman and Torgerson, the most signifi cant allergens were fra-grance mixes, Myroxilon pereirae resin, dodecyl gallate, octyl gallate, and benzoic acid13. Actinic keratosis is diagnosed by a combination of clinical and dermoscopic features and sometimes can be difficult to distinguish from other lesions. 37 Full PDFs related to this paper. Download with Google Download with Facebook. It is a premalignant condition, as it can develop into squamous cell carcinoma (a type of mouth cancer It is essential to distinguish between cheilitis (benign inflammation), premalignant actinic cheilitis, and squamous cell carcinoma. Actinic cheilitis (also known as "farmer's lip" or "sailor's lip"') represents confluent actinic keratoses on the lips, most often the lower lip. AC may be painless, but it can lead to 255-64. David Picascia. Like discrete actinic keratoses, actinic cheilitis is also a premalignant condition related to cumulative lifetime sun exposure. Actinic cheilitis is a lesion of the lip that is analogous to actinic keratosis. Create a free account to download. or. Generally, the forms most commonly reported in the literature are angular, contact (allergic and irritant), actinic, glandular, granulomatous, exfoliative and plasma cell cheilitis. Dermatology, pp.1090-1091. The differential diagnosis of AC includes actinic lichen planus (ALP), herpes simplex lesions, exfoliative cheilitis, contact cheilitis (CC), autoimmune blistering disease including pemphigus vulgaris (PV), lichenoid drug eruptions, cheilitis granulomatosa (CGM), cheilitis grandularis (CGL), and early carcinoma in situ (CIS) [11, 12]. Typically, they occur in middle-aged or older men with light-coloured skin and a history of chronic sun exposure. It is essential to distinguish between cheilitis (benign inflammation), premalignant actinic cheilitis, and squamous cell carcinoma. Lesions occur almost exclusively on the lower lip, predominantly at the vermillion border, thus reinforcing its direct relationship with the sun. J Am Acad Dermatol 17 (2 Pt 1): 255-64. Relevant allergens related to contact cheilitis: fragrant substances, peruvian balm and nickel. They can potentially progress into squamous cell carcinoma (SCC). (Picascia and Robinson give a comprehensive review of the etiology, clinical spectrum, histology, and treatment options for actinic cheilitis. Differential diagnosis. "Actinic cheilitis: a review of the etiology, differential diagnosis, and treatment.". Factitious cheilitis is a chronic condition characterized by crusting and ulceration that is probably secondary to chewing and sucking of the lips. Clinical reviews II I I III II I II I Actinic cheilitis: A i:eview of the etiology, differential diagnosis, and treatment David D. Picascia, M.D., and June K. Robinson, M.D. The clinical appearance and histologic aggressiveness cannot be evaluated clinically (Manganaro et al., 1997) and the clinician must rely on histological examination of the tissues for a correct diagnosis. Differential diagnosis can include chronic lip licking, granulomatous cheilitis, drug-induced cheilitis, contact dermatitis, cheilitis glandularis, lupus erythematosus, and lichen planus. 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