Actinic cheilitis - Oral Mucosal Lesion
Alerts and Notices
Synopsis
Individuals with actinic cheilitis often present with complaints of persistent dryness and cracking of the lips. They will frequently exhibit other cutaneous manifestations of sun damage (eg, actinic keratoses, poikiloderma of Civatte, actinic comedones).
Squamous cell carcinoma (SCC) develops in 10%-30% of cases of actinic cheilitis.
Codes
ICD10CM:K13.0 – Diseases of lips
SNOMEDCT:
46795000 – Actinic cheilitis
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Contact dermatitis
- Chronic lip licking
- Granulomatous cheilitis (Melkersson-Rosenthal disease)
- Oral SCC (see also cutaneous SCC)
- Drug-induced cheilitis (isotretinoin and other retinoids)
- Cheilitis glandularis
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:11/02/2020
Last Updated:11/02/2020
Last Updated:11/02/2020
Patient Information for Actinic cheilitis - Oral Mucosal Lesion
Overview
Actinic cheilitis, sometimes known as "farmer's lip" or "sailor's lip," is a precancerous condition related to cumulative lifetime sun exposure. The lower lip is most often affected. Individuals with actinic cheilitis often complain of persistent dryness and cracking of the lips. They will frequently exhibit other effects of sun-damaged skin, such as precancerous lesions on the skin called actinic keratoses and extensive wrinkling.A certain type of skin cancer (squamous cell carcinoma) develops in 6% to 10% of cases of actinic cheilitis.
Who’s At Risk
Actinic cheilitis is significantly more common in men, the elderly, and individuals with light skin colors.Signs & Symptoms
Actinic cheilitis is located on the lips, most often the lower lip. Persistent redness, scaliness, and chapping are among the symptoms noted. Erosions and cracks (fissures) may be present as well.Self-Care Guidelines
Prevention is very important. Wearing barrier clothing (eg, wide-brimmed hats) and sunscreen-containing lip balms can aid in preventing actinic cheilitis.When to Seek Medical Care
Seek the evaluation of a primary care provider or dermatologist when persistent scaling of the lips is noted. A biopsy of the lip may be needed to rule out squamous cell carcinoma.Treatments
In severe cases without evidence of malignancy, a lip shave procedure (vermilionectomy) may be performed. In less extreme cases, your physician may recommend destruction (ablation) of the damaged cells with a carbon dioxide (CO2) laser.Alternative treatments include the use of electric current to destroy the precancerous cells (electrodesiccation) and a facial sanding technique (dermabrasion). Topical therapy with a chemotherapeutic agent (fluorouracil) or a topical immunomodulator (imiquimod) may be prescribed.
References
Bolognia, Jean L., ed. Dermatology, pp.1090-1091. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp. 721-725, 741. New York: McGraw-Hill, 2003.
Actinic cheilitis - Oral Mucosal Lesion