2016, Number 2
<< Back Next >>
Rev Cubana Estomatol 2016; 53 (2)
Actinic cheilitis: histological, clinical and epidemiological characteristics
Hernández OC, Fuentes PB, Cartes-Velásquez R
Language: Spanish
References: 69
Page: 45-55
PDF size: 366.13 Kb.
ABSTRACT
Introduction: depletion of the ozone layer has brought about an increase in the incidence of skin lesions, including actinic cheilitis.
Objective: describe the histological, clinical and epidemiological characteristics of actinic cheilitis based on a review of recent literature.
Methods: a search was conducted in the databases PubMed, SciELO and Google Scholar using the descriptors cheilitis, keratosis, actinic, solar, and their counterparts in Spanish. The search included original papers, review papers, case reports, theses and books about the specialty preferably published from 2005 to 2014.
Results: actinic cheilitis is a potentially malignant condition induced by sun exposure and characterized by micro- and macrostructural alterations of the lip. The risk factors interacting with sun exposure are the skin phototype (light skin), smoking, gender (male), age and occupation (outdoor jobs). Histological alterations include epithelial dysplasia and solar elastosis, though their severity does not correlate with the degree of clinical seriousness. Patients with actinic cheilitis present color alterations, desquamation, ulceration and blurring of the vermillion border, among other signs and symptoms. On many occasions patients do not seek care during the early stages of the disease. As a result, diagnosis is made when the condition has already evolved into cancer. The diagnosis is basically clinic, with the support of the biopsy of lesions with moderate to severe characteristics. Current therapy includes surgery and medication, as well as innovative techniques like phototherapy. The most important strategy is no doubt the use of sunscreens, especially by the population at high occupational risk.
Conclusions: actinic cheilitis is a condition relevant to South American countries, since its risk factors are present in the daily activities of millions of workers from our region. It is therefore necessary to foster research aimed at improving its prevention, treatment and rehabilitation.
REFERENCES
Bauer A, Diepgen TL, Schmitt, J. Is occupational solar ultraviolet irradiation a relevant risk factor for basal cell carcinoma? A systematic review and meta‐analysis of the epidemiological literature. Br J Dermatol. 2011;165(3):612-25.
Rivas M, Araya MC, Caba F, Rojas E, Calaf GM. Ultraviolet light exposure influences skin cancer in association with latitude. Oncol Reports. 2011;25(4):1153-9.
Surdu S, Fitzgerald EF, Bloom MS, Boscoe FP, Carpenter DO, Haase RF, Gurzau E, Rudnai P, Koppova K, Févotte J, Leonardi G, Vahter M, Goessler W, Kumar R, Fletcher T. Occupational exposure to ultraviolet radiation and risk of non-melanoma skin cancer in a multinational European study. PloS One. 2013;8(4):e62359.
D'Orazio J, Jarrett S, Amaro-Ortiz A, Scott T. UV Radiation and the Skin. Int J Mol Sc. 2013;14(6):12222-48.
Velásquez M, Zuluaga de Cadena A. Primera jornada de detección precoz del cáncer de piel, Asocolderma 2011, reporte de la experiencia en Medellín, Colombia. Rev Asoc Colomb Dermatol. 2012;20:2,135-46.
Martins-Filho P, Da Silva L, Piva M. The prevalence of actinic cheilitis in farmers in a semi-arid northeastern region of Brazil. Int J Dermatol. 2011;50(9):1109-14.
Lucena E, Costa D, Silveira É, Lima K. Prevalence and factors associated with orolabial lesions in beach workers. Rev Saude Publ. 2012;46(6):1051-7.
Slama B. Potentially malignant disorders of the oral mucosa: terminology and classification. Rev Stomatol Chir Maxillofac. 2010;111(4):208-12.
Waal I. Potentially malignant disorders of the oral and oropharyngeal mucosa, terminology, classification and present concepts of managemet. Oral Oncology. 2009;45:317-23.
de Santana S, Da Costa M, Queiroz L, Godoy G, da Silveira E. Actinic cheilitis: clinicopathologic profile and association with degree of dysplasia. Int J Dermatol. 2014;53(4):466-72.
Piñera-Márquez K, Lorenco S, Silva L, Sotto M, Carneiro P. Actinic lesions in fishermen's lower lip: clinical, cytopathological and histopathologic analysis. Clinics. 2010;65(4):363-7.
Carneiro L, de Castro BR. Actinic cheilitis profile of the scientific production in dentistry of Brazil in the last ten years. Rev Cubana Estomatol. 2012;49(4):276-85.
Horsham C, Auster J, Sendall M, Stoneham M, Youl P, Crane P, Tenkate T, Janda M, Kimlin M. Interventions to decrease skin cancer risk in outdoor workers: update to a 2007 systematic Review. BMC Res Notes. 2014;7:10.
de Souza Lucena E, Costa D, Da Silveria E, Lima k. Prevalence and factors associated to actinic cheilitis in beach workers. Oral Dis. 2012;18(6):575-9.
Volkov A, Dobbinson S, Wakefield M, Slevin T. Seven‐year trends in sun protection and sunburn among Australian adolescents and adults. ANZ J Pub Health 2013;37(1):63-9.
Puga P. Parámetros de riesgo de la queilitis actínica crónica [Tesis doctoral]. Granada. Facultado de Odontología Departamento de Estomatología, Universidad de Granada; 2009.
Testur L, Latarjet A. Compendio de anatomia descriptiva. Barcelona: Elsevier España; 2011.
Savage N, McKay C, Faulkner C. Actinic cheilitis in dental practice. Aust Dent J. 2010;55(1):78-84.
Hasan S, Ishrat N, Asif S. Actinic Cheilitis -a premalignant condition- review of literature. Guident. 2012[En línea]. 2012 [Consultado: 1 abril de 2014]. Disponible en: http://www.guident.net/oral-medicine/actinic-cheilitis-a-premalignant-condition-review-of-literature.html
Orozco P, Vásquez S, Venegas B, Rivera C. Prevalencia de queilitis actínica en trabajadores expuestos a radiación ultravioleta en Talca, Chile. Rev Clin Periodoncia Implantol Rehabil Oral. 2013;6(3):127-29.
Bertini F, Sgarbi F, Tero T, Brandaö A, Cavalcante A. Histological analysis of the actinic cheilitis: an interobserver approach. Int J Dent. 2010;9(1):6-10.
Regezi J, Sciubba J. Oral Pathology: Clinical Pathologic Correlations. Philadelphia: Saunders; 2011.
Krüger-Corcoran D, Vandersee S, Stockfleth E. Precancerous tumors and carcinomas in situ of the skin. Internist. 2013;54(6):671-82.
Amishi Y, Shah D, Doherty MD, Ted R. Actinic cheilitis: a treatment review. Int J Dermatol. 2010;49:1225-34.
Neville B, Damm D, Allen C, Saunders WB. Oral and Maxillofacial Pathology. United Sates: Saunders Company; 2002.
Reinau D, Weiss M, Meier CR, Diepgen TL, Surber C. Outdoor workers' sun‐related knowledge, attitudes and protective behaviours: a systematic review of cross‐sectional and interventional studies. Br J Dermatol. 2013;168(5):928-40.
Ezzedine K, Guinot C, Mauger E, Pistone T, Rafii N, Receveur MC, Galan P, Hercberg S, Malvy D. Expatriates in high-UV index and tropical countries: sun exposure and protection behavior in 9,416 French adults. J Travel Med. 2007;14(2):85-91.
Aguilera J, Victoria de Gálvez M, Conde R, Pérez-Rodríguez E, Viñegla B, Abdala R, Segovia M, Herrera E, Figueroa F. Series temporales de medida de radiación solar ultravioleta y fotosintética en Málaga. Actas Dermosifiliogr. 2004;95(1):25-31.
Diepgen TL, Fartasch M, Drexler H, Schmitt J. Occupational skin cancer induced by ultraviolet radiation and its prevention. Br J Dermatol. 2012;167(2):76-84.
Sambandan DR, Ratner D. Sunscreens: an overview and update. J Am Acad Dermatol. 2011;64(4):748-58.
Bezerra S, Sotto M, Orii N, Alves C, Duarte A. Effects of long-term chronic exposure to sun radiation in immunological system of commercial fishermen in Recife, Brazil. An Bras Dermatol. 2011;86(2):222-33.
Hamilton N, Khammissa R, Meyerov R, Lemmer J, Feller L. Actinic cheilitis: a case report and a review of the literature. Eur J Dent. 2011;5(1):101-6.
Andrade M, Pedreira L, Aquino F, Gomes A, Almeida S. p53 and MDM2 protein expression in actinic cheilitis. J Appl Oral Sci. 2008;16(6):414-9.
Markopoulos A, Albanidou-Farmaki E, Kayayis I. Actinic cheilitis: clinical and pathologic characteristics in 65 cases. Oral Dis. 2004;10(4):212-6.
Nicolini S, Ascorra C, Guzman C, Latife A. Actinic cheilitis in Quinta fishing workers: prevalence and associated histopathological aspects. Odontol Chil. 1989;37(1):169-74.
Purim K, Leite N. Sports-related dermatoses among road runners in Southern Brazil. An. Bras. Dermatol. Sifilog. 2014;89(4):587-92.
Goldsmith L, Katz S, Gilchrest B, Paller P, Leffell D, Wolff K. Fitzpatrick's Dermatology in General Medicine. Nueva York: McGraw-Hill Professional; 2012.
Horsham C, Auster J, Sendall MC, Stoneham M, Youl P, Crane P, Tenkate T, Janda M, Kimlin M. Interventions to decrease skin cancer risk in outdoor workers: update to a 2007 systematic review. BMC Res Notes. 2014;7:10.
Cavalcante A, Anbinder A, Carvalho Y. Actinic cheilitis: clinical and histological features. J Oral Maxillofac Surg. 2008;66(3):498-503.
Ochsenius G, Ormeño A, Godoy L, Rojas R. Estudio retrospectivo de 232 casos de cáncer y precáncer de labio en pacientes chilenos. Correlación clínico-histológica. Rev Méd Chile. 2003;131:60-6.
Miranda A, Soares L, Ferrari T, Silva D, Falabella M, Tinoco E. Prevalence of actinic cheilitis in a population of agricultural sugarcane workers. Acta odontol latinoam. 2012;25(2):201-6.
Oliveira A, da Silva L, Martins‐Filho P. Prevalence of and risk factors for actinic cheilitis in Brazilian fishermen and women. Int J Dermatol. 2014;53:1370-76.
Asawa K, Pujara P, Tak M, Nagarajappa R, Aapaliya P, Bhanushali N, Mishra P, Sharma A. Oral health status of fishermen and non-fishermen community of Kutch district, Gujarat, India: a comparative study. Int Marit Health. 2014;65(1):1-6.
Haddad V, Lupi O, Lonza J, Tyring S. Tropical dermatology: marine and aquatic dermatology. J Am Acad Dermatol. 2009;61(5):733-50.
Aguirre P, Aguirre JM. Displasia epitelial. Concepto y significación. Av Odonto Estomatol. 2008;24(1):81-8.
Paiva M, Soares M, Figueiredo C, Luna A, Oliveira V. Association between dysplasia and inflammation in actinic cheilitis. J Bras Patol Med Lab. 2012;48(6): 455-8.
Araújo C, Xavier F, Gugel C, Ramos E, Freitas V, Schlaepfer-Sales C, Ramalho L. Elastin accumulation in actinic cheilitis with different degrees of epithelial dysplasia. Int J Morphol. 2012;30(2) 627-33.
Poulopoulos A, Andreadis D, Markopoulos A.Expression of matrix metalloproteinases 9 and 12 in actinic cheilitis. World J Exp Med. 2013;20(3):43-49.
Fontes A, Souza S, Dos Santos E, Martíns M. The severity of epitelia displasia is associated with loss of maspin expression in actinic cheilitis. J Cutan Pathol. 2009; 36:1151-6.
Sánchez D, Alcalá Daniel, Peralta ML, Vega M, Medina A, Valenzuela A, Torres L. Guía de práctica clínica para diagnóstico y tratamiento de la queratosis actínica. Dermatol Rev Mex. 2012;56(1):14-25.
Manganaro A, Will M, Poulos E. Actinic cheilitis: a premalignant condition. Gen Dent. 1997;45(5):492-4.
Spyridonos P, Gaitanis G, Tzaphlidou M, Bassukas ID. Spatial fuzzy c-means algorithm with adaptive fuzzy exponent selection for robust vermilion border detection in healthy and diseased lower lips. Comp Meth Prog Biomed 2014;114(3):291-301.
Sgarbi FC, Bertini F, Tera TM, Cavalcante AR. Morphology of collagen fiber and elastic system fiber in actinic cheilitis. Indian J Dent Res. 2010;21:518-22.
Kurachi C, Cosci A, Takahama A, Fontes KBFC, Azevedo RS. Widefield fluorescence imaging as an auxiliary tool to select the biopsy site for actinic cheilitis diagnosis. SPIE BiOS. 2014;892627-892627.
Shin MS, Lee UH, Park HS, Park HJ. Clinical and Histopathological Analysis of Inflammatory Lesions on the Lips. Korean J Dermatol. 2013;51(8):608-15.
Bravo F. Caracterización clínica-histológica de lesiones de queilitis actínica crónica refractaria al tratamiento con betametazona tópica en individuos de riesgo de la ciudad de Talca entre marzo y octubre del 2011. Memoria para optar al título de cirujano dentista. Talca: Universidad de Talca; 2011.
Lucena E, Castro A, Farias D, Lima P, Silveira E, Lima K. Prevalence of lip and perioral Ephelides in beach workers. An Bras Dermatol. 2013;88(1):56-63.
Zanetti R, Florio M, Moraes P. Prevalence of actinic cheilitis in an oral health campaign in the city of Campinas, SP. J Appl Oral Sci. 2009;15:353.
Espinoza I, Rojas R, Aranda W, Gamonal J. Prevalence of oral mucosal lesions in elderly people in Santiago, Chile. J Oral Pathol Med. 2003;32(10):571-5.
Ribeiro CF, Souza FHD, Jordão JM, Haendchen LC, Mesquita L, Schmitt JV, Faucz LL. Photodynamic therapy in actinic cheilitis: clinical and anatomopathological evaluation of 19 patients. An Bras Dermatol. 2012;87(3):418-23.
Ghasri P, Admani S, Petelin A, Zachary CB. Treatment of Actinic Cheilitis Using a 1,927‐nm Thulium Fractional Laser. Dermatol Surg. 2012;38(3):504-7.
Cohen JL. Erbium laser resurfacing for actinic cheilitis. J Drugs Dermatol. 2013;12(11):1290-92.
LLamas S, Esparza G, Moreno La, Cerero R. Corticoides: Su uso en patología de la mucosa oral. Med Oral. 2003;8:248-59.
Lima G, Silva G, Gomes A, Araujo L, Alum F. Diclofenac in hyaluronic acid gel: an alternative treatment for actinic cheilitis. J Appl Oral Sci. 2009;18(5):533-7.
Duquia R, Baptista A, Reichert F, De Almeida H. Prevalence and associated factors with sunscreen use in Southern Brazil: A population-based study. J Am Acad Dermatol. 2007;57(1):73-80.
Reinau D, Weiss M, Meier CR, Diepgen TL, Surber C. Outdoor workers' sun-related knowledge, attitudes and protective behaviours: a systematic review of cross-sectional and interventional studies. Br J Dermatol. 2013;168(5):928-40.
Buller DB, Cokkinides V, Hall HI, Hartman AM, Saraiya M, Miller E, Paddock L, Glanz K. Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. J Am Acad Dermatol. 2011;65(5):114-23.
Lucena E, Costa D, Silveira E, Lima K. Adoption of photoprotection measures on lip and perioral regions among beach workers in North Brazil. Int J Dermatol. 2014;53(11):480-5.
Suassuna P, de Castro R. Queilite actínica-perfil da produção científica em odontologia do Brasil nos últimos dez anos. Rev Cubana Estomatol. 2012;49(4):276-85.