Clinicopathological profile and management of 161 cases of actinic cheilitis

Lopes, Maria Luiza Diniz de Sousa; Silva Júnior, Francisco Leonardo da; Lima, Kenio Costa; Oliveira, Patrícia Teixeira de; Silveira, Éricka Janine Dantas da

doi:10.1590/abd1806-4841.20153848

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Investigation • An. Bras. Dermatol. 90 (4) • Jul-Aug 2015 • https://doi.org/10.1590/abd1806-4841.20153848 copy

Clinicopathological profile and management of 161 cases of actinic cheilitis^* * Work performed at the Departamento de odontologia da Universidade Federal do Rio Grande do Norte (UFRN) - Natal (RN), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

BACKGROUND:

Actinic cheilitis (AC) is a potentially malignant disorder of the lip caused by chronic exposure to ultraviolet radiation from the sun.

OBJECTIVES:

To evaluate the clinical, demographic, morphological and therapeutic management in AC cases data associating to the histopathological grading.

METHODS:

Demographic, clinical and management data of 161 patients with AC were analyzed. In biopsied cases, two calibrated examiners performed histopathological grading by binary system.

RESULTS:

There was a prevalence of males (79.5%), aged 40 years or older (77.5%), light-skinned (85.7%), experiencing occupational exposure to sunlight (80.3%), with AC presenting clinically as white lesions (33.6%). Conservative treatment was adopted in 78 cases and biopsy in 83 cases (60.2% graded as low-risk AC). There were no significant associations between histopathological grading and gender (p= 0.509), age (p=0.416), ethnicity (p=0.388), occupational exposure to sunlight (p=1.000) or clinical presentation (p=0.803).

CONCLUSION:

This study reinforces the hypothesis that demographic and clinical characteristics of AC are not related to histopathological grading. Advice on protection from sun exposure should be encouraged to avoid progression of AC and invasive therapies.

Keywords:
Cheilitis; Lip; Therapeutical approaches; Ultraviolet rays

	n	%
Gender
Male	128	79.5
Female	33	20.5
Total	161	100
Age
> 40 years	125	77.5
< 40 years	36	22.5
Total	161	100
Ethnicity
White	120	85.7
Mixed race	19	13.6
Black	01	0.7
Total^a a Missing data;	140	100
Occupational solar exposure
Yes	118	80.3
No	29	19.7
Total^a a Missing data;	147	100
Smoker
Yes	42	29.3
No	101	70.7
Total^a a Missing data;	143	100
Alcohol consumption
Yes	21	14.7
No	122	85.3
Total^a a Missing data;	143	100
Histopathological Grade
High-Risk	33	39.8
Low-Risk	50	60.2
Total^b b Data refers only to biopsied cases.	83	100

Variable		Age
		≥ 40 years	< 40 years	TOTAL
		n (%)	n (%)	n (%)
Gender	Male	97 (75.8)	31 (24.2)	128 (100)
	Female	28 (84.8)	5 (15.2)	33 (100)
	Total	125 (77.6)	36 (22.4)	161 (100)
	White	94 (78.3)	26 (21.7)	120 (100)

Ethinicity	Mixed raceBlack	14 (70.0)	06 (30.0)	20 (100)
	Total^a a Missing data;	108 (77.1)	32 (22.9)	140 (100)

Occupational sunlight exposure	Yes	97 (82.2)	21 (17.8)	118 (100)
	No	19 (65.5)	10 (34.5)	29 (100)
	Total^a a Missing data;	116 (78.9)	31 (21.1)	147 (100)

Smoker	Yes	39 (92.9)	03 (7.1)	42 (100)
	No	74 (73.3)	27 (26.7)	101 (100)
	Total^a a Missing data;	113 (79.0)	30 (21.0)	143 (100)

Drinker	Yes	18 (85.7)	03 (14.3)	21 (100)
	No	94 (77.0)	28 (23.0)	122 (100)
	Total^a a Missing data;	112 (78.3)	31 (21.7)	143 (100)

Clinical Appearence	White lesion	37 (78.7)	10 (23.1)	47 (100)
	Red / White and red lesion	63 (84.0)	12 (16.0)	75 (100)
	Total^b b Some cases did not show the clinical aspects categorized.	100 (82.0)	22 (18.0)	122 (100)

		Gender
Variable		Male	Female	TOTAL
		n (%)	n (%)	n (%)
Age	≥ 40 years	97 (77.6)	28 (22.4)	125 (100)
	< 40 years	31 (86.1)	5 (13.9)	36 (100)
	Total	128 (79.5)	33 (20.5)	161 (100)

	White	99 (82.5)	21 (17.5)	120 (100)
Ethinicity	Mixed race/Black	15 (80.0)	05 (20.0)	20 (100)
	Total^a a Missing data;	114 (81.4)	26 (18.8)	140 (100)

Occupational sunlight exposure	Yes
	No	101 (85.6)	19 (65.5)	17 (14.4)
		10 (34.5)	118 (100)	29 (100)
	Total^a a Missing data;	120 (81.6)	27 (18.4)	147 (100)

Smoker	Yes	35 (83.3)	07 (16.7)	42 (100)
	No	78 (77.2)	23 (22.8)	101 (100)
	Total^a a Missing data;	113 (79.0)	30 (21.0)	143 (100)

Drinker	Yes	18 (85.7)	03 (14.3)	21 (100)
	No	95 (77.9)	27 (22.1)	122 (100)
	Total^a a Missing data;	113 (79.0)	30 (21.0)	143 (100)

Clinical Appearence	White lesion	38 (80.9)	9 (19.1)	47 (100)
	Red / White and red lesion	60 (80.0)	15 (20.0)	75 (100)
	Total^b b Some cases did not show the clinicai aspects categorized.	98 (80.3)	24 (19.7)	122 (100)

		Occupational sunlight exposure^† † This information was available only in 147 cases;
Variable		Yes	No	TOTAL
		n (%)	n (%)	n (%)
Age	≥ 40 years	97 (83.6)	19 (16.4)	116 (100)
	< 40 years	21 (63.0)	10 (37.0)	31 (100)
	Total	118 (80.3)	29 (19.7)	147 (100)

Gender	Male	101 (84.2)	19 (15.8)	120 (100)
	Female	17 (63.0)	10 (37.0)	27 (100)
	Total	118 (80.3)	29 (19.7)	161 (100)

	White	93 (80.2)	23 (19.8)	116 (100)
Ethinicity	Mixed race/Black	15 (79.0)	04 (21.0)	19 (100)
	Total^a a Missing data;	108 (80.0)	27 (20.0)	135 (100)

Smoker	Yes	35 (85.3)	06 (14.7)	41 (100)
	No	75 (78.1)	21 (21.9)	96 (100)
	Total^a a Missing data;	110 (80.3)	27 (19.7)	137 (100)

Drinker	Yes	20 (95.2)	01 (4.8)	21 (100)
	No	90 (77.6)	26 (22.4)	116 (100)
	Total^a a Missing data;	110 (80.3)	27 (19.7)	137 (100)

Clinical Appearence	White lesion	32 (72.7)	12 (27.3)	44 (100)
	Red / White and red lesion	65 (89.0)	08 (11.0)	73 (100)
	Total^b b Some cases did not show the clinical aspects categorized.	97 (82.9)	20 (17.1)	117 (100)

Variable		Histopathological Grading
		High-Risk	Low-Risk	TOTAL	p
		n (%)	n (%)	n (%)

Gender	Male	28 (38.4)	45 (61.6)	73 (100)	0.509^* * Fisher's exact test;
	Female	05 (50.0)	05 (50.0)	10 (100)
	Total	33 (39.8)	50 (60.2)	83 (100)

Age	≥ 40 years	09 (50.0)	09 (50.0)	18 (100)	0.416^ Pearson's chi-squared test;
	< 40 years	24 (36.9)	41 (68.1)	65 (100)
	Total	33 (39.8)	50 (60.2)	83 (100)

	White	29 (43.9)	37(56,1)	66(100)	0.388^* * Fisher's exact test;
Ethinicity	Mixed race⁄Black	01 (20.0)	04(80,0)	05(100)
	Total^a a Missing data;	30(42,3)	41(57.7)	71(100)

Occupational sunlight exposure
	Yes	40 (62.5)	08 (61.5)	24 (37.5)
	No	05 (38.5)	64 (100)	13 (100)	1.000^* * Fisher's exact test;
	Total^a a Missing data;	48 (62.3)	29 (37.7)	77 (100)

Smoker	Yes	08 (57.1)	06 (42.9)	14 (100)	0.230^ Pearson's chi-squared test;
	No	23 (37.1)	39 (62.9)	62 (100)
	Total^a a Missing data;	31 (40.8)	45 (59.2)	76 (100)

Drinker	Yes	01 (25.0)	03 (75.0)	04 (100)	1.000^* * Fisher's exact test;
	No	28 (40.0)	42 (60,0)	70 (100)
	Total^a a Missing data;	29 (39.2)	45 (60.8)	74 (100)

Clinical Appearence	White lesion	22 (62.7)	12 (35.8)	34 (100)	0.803^ Pearson's chi-squared test;
	Red / White and red lesion	20 (58.8)	14 (41.2)	34 (100)
	Total^b b Some cases did not show the clinical aspects categorized.	42 (61.8)	26 (38.2)	68 (100)

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E-mail: revista@sbd.org.br

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Signs and Symptoms	n	%

White plaques	48	33.6
Red and white plaques	38	26.6
Red plaques	37	25.9
Pigmented areas	9	5.6
Ulceration	9	5.6
Pain	23	28.4
Stinging/burning lips	20	24.7

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Clinicopathological profile and management of 161 cases of actinic cheilitis* * Work performed at the Departamento de odontologia da Universidade Federal do Rio Grande do Norte (UFRN) - Natal (RN), Brazil.

Abstract

BACKGROUND:

OBJECTIVES:

METHODS:

RESULTS:

CONCLUSION:

Clinicopathological profile and management of 161 cases of actinic cheilitis^* * Work performed at the Departamento de odontologia da Universidade Federal do Rio Grande do Norte (UFRN) - Natal (RN), Brazil.