A chronicly scaly, crusted papule on the lower lip.

ACTINIC CHEILITIS

Actinic Cheilitis is inflammation of the lower lip caused by chronic sun exposure.

• The lower lip receives much more sun exposure than the upper lip. Over time, chronic photodamage may develop.
• The development of ulceration and/or nodularity/thickness may herald the development of SCC, which on the lip is more likely to metastesize.
  

The typical early changes are scaly, hyperkeratotic areas along the edge of the lip adjacent to the vermilion border. Only limited areas may be involved in mild disease. For extensive damage, the entire lower lip may be involved. A solitary white plaque (leukoplakia) of the lower lip is a common presentation. The edge closest to the oral cavity is usually well-defined whereas the edge closest to the skin fades out gradually.

One key characteristic of actinic cheilitis is that just the lower lip is involved in contrast to allergic contact dermatitis where both the upper and lower lip show changes.

The healthcare provider should put on a glove and palpate the lip to exclude any nodularity or induration suggestive of a squamous cell carcinoma (SCC). A complete skin examination to look for skin cancers should also be performed.

Leukoplakia. This lesion has to go! If allowed to persist, squamous cell carcinoma may develop.

RegionalDerm

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