Actinic cheilitis is a chronic inflammatory disease of the lips that occurs due to pathological sensitivity (sensitization) to the effects of ultraviolet light. It is characterized by a burning sensation, itching, stagnant hyperemia, swelling and peeling of the red border of the lips. Actinic cheilitis is diagnosed on the basis of anamnesis, symptoms detected during examination and biopsy results. Treatment of the disease includes vitamin therapy, topical use of corticosteroid drugs and decoctions of medicinal plants. The patient is recommended to limit the time spent in the sun and use protective equipment against the irritating effects of rays.
ICD 10
K13.0 Lip diseases
General information
Actinic cheilitis is an inflammation of the lip tissues, which is an allergic reaction to the action of ultraviolet light. The disease has a chronic recurrent character; periods of exacerbations usually occur during the warm season, as they are closely related to solar activity. In the autumn-winter period, the symptoms of pathology usually disappear on their own. Actinic cheilitis is most often observed in men aged 30-60 years with fair skin, but it can also occur in children due to long exposure to the sun. It is not uncommon for actinic cheilitis to accompany other forms of increased photosensitivity of the skin, for example, solar dermatitis. In the presence of additional risk factors (smoking, etc.), malignant transformation (malignancy) of the affected areas of the lips is possible.
Causes of actinic cheilitis
The cause of actinic cheilitis is a delayed allergic reaction caused by pathological sensitivity to ultraviolet rays. Sensitization often occurs against the background of pathologies of the liver, gallbladder and other organs of the gastrointestinal tract (hepatitis, chronic cholecystitis, pancreatitis, gastritis, peptic ulcer of the 12p. intestine).
Classification
In therapeutic dentistry, there are two forms of the disease: exudative and dry.
- The exudative form of actinic cheilitis is manifested by swelling and hyperemia of the lips, as well as the appearance of erythema and small bubbles on them. The patient feels itching, burning, sometimes soreness. After a short time, the bubbles are opened, leaving behind small erosions, later covered with crusts. With a long chronic course of the disease, the affected skin becomes rough in places and partially keratinized, ulcers and cracks form on it.
- The dry form of actinic cheilitis manifests itself by redness, dryness and peeling of the lips. Small scales appear on their surface, sometimes local keratinization with ulcers and cracks may also occur.
Symptoms of actinic cheilitis
Manifestations almost always develop on the lower lip, which is more exposed to sunlight, and the upper lip is involved in the pathological process extremely rarely. The exudative form of the disease is characterized by clinical symptoms of acute allergic contact dermatitis. At the same time, the lip border swells slightly, areas of redness (erythema) and small bubbles form on it. Soon they spontaneously burst, leaving behind small wet erosions. In the future, crusts form on the surface of erosive defects, which subsequently independently depart.
With a long course, this form of the disease causes changes in the tissues that do not disappear during periods of remission. The skin of the red border becomes rough, local keratinization can be observed. Subsequently, quite significant ulcers or cracks appear.
The dry form of actinic cheilitis is manifested by a bright red tint of the lip border and the formation of small dry scales of silver color on its surface. Local keratinization and focal verrucous growths can be observed. In the presence of additional factors (smoking, staying in dusty rooms, etc.) this form of the disease has a tendency to malignancy and often flows into precancerous pathologies – abrasive precancerous Manganotti cheilitis, limited hyperkeratosis, etc.
Complications
Actinic cheilitis in any form can serve as a favorable background for the occurrence of an oncological process, therefore, all formations in the affected area that have existed for a long time must be subjected to histological examination. Due to the high probability of developing carcinoma due to the chronic course of actinic cheilitis, patients should be regularly monitored by a doctor.
Diagnostics
Actinic cheilitis is diagnosed by a dentist during an examination based on a detailed anamnesis and clinical symptoms. It is extremely important to identify the seasonality of the manifestations of the pathological process – this helps to differentiate the disease from atopic and exfoliative cheilitis, as well as lupus erythematosus.
In case of persistent preservation of signs of pathology after 10-14 days of rational therapy, as well as in the presence of long-term existing erosions, cracks and other formations in the affected area, a biopsy is required to exclude the oncological nature of the disease.
Treatment of actinic cheilitis
Therapy of actinic cheilitis, first of all, implies the elimination of the cause causing the pathological process – prolonged exposure to ultraviolet radiation. The patient is recommended to spend as little time in the sun as possible and change his profession if it is associated with a long stay on the street.
Drug treatment includes vitamin therapy (especially important vitamins of group B, A, E, P, C) in combination with small doses of corticosteroids and antimalarial drugs. When applied topically, ointments with corticosteroids have an excellent effect. In addition, vitamins A and E are used in oil, applications with methyluracyl ointment, as well as dental adhesive paste.
Also, when treating actinic cheilitis, lotions and rinsing with decoctions of medicinal plants (for example, St. John’s wort, calendula flowers, etc.) can benefit. Regarding the use of these funds, it is necessary to consult a doctor.
Prognosis and prevention
As a rule, therapeutic measures in the case of actinic cheilitis quickly lead to a significant improvement in the condition, and the prognosis is most often favorable. However, patients should remember that actinic cheilitis has a tendency to malignant degeneration. If there is no effect from the treatment, or the situation worsens, additional examinations should be urgently carried out.
To prevent actinic cheilitis, it is necessary to avoid the irritating effects of ultraviolet radiation. It is necessary to try to be under the bright sun as little as possible, especially in the spring and summer period, when the probability of exacerbations increases. The use of photoprotective creams is also shown, but they should be used with caution, since cosmetics themselves can cause allergic reactions. On sunny days, patients are recommended to wear a wide-brimmed hat or umbrella – this allows them to protect their face from ultraviolet rays.
In the presence of general somatic pathologies, such as diseases of the liver, gallbladder and other organs of the gastrointestinal tract, it is necessary to treat them in a timely manner, since actinic cheilitis very often accompanies these diseases.
