Warty precancerous of the red border of the lips is a pathological process in the area of the red border of the lips with a high probability of malignant degeneration. It belongs to the group of obligate precancerous diseases, can undergo a malignant transformation within 1-2 months. It is a rounded, lumpy, painless nodule, usually located on the right or left side of the lower lip. The color of the nodule can vary from the usual, coinciding with the color of the lip border to stagnant red. The diagnosis is established on the basis of a survey, examination and additional research data. The treatment is operative.
Warty precancerous of the red border of the lips is a benign formation in the area of the red border of the lips, rapidly undergoing malignant degeneration. Precancerous is understood as a pathological condition that necessarily precedes the appearance of a malignant neoplasm, but does not always turn into such a neoplasm. Facultative precancers are conditions with a relatively low risk of malignancy, obligate precancers are conditions with a high probability of malignant degeneration.
The warty precancer of the red border of the lips belongs to the group of obligate precancers. Only 1-2 months are enough for malignancy. It is usually detected in men over 40 years of age. It occurs under the influence of a number of exogenous and endogenous factors. It does not cause unpleasant symptoms or a gross cosmetic defect, which causes patients to go to the doctor later and increases the likelihood of malignant degeneration. The treatment of this disease is carried out by specialists in the field of oncology – dermatooncologists.
Causes of the development of warty precancerous red lip border
Along with other similar diseases of the red border of the lips and the oral mucosa develops under the influence of adverse external (mechanical, chemical, thermal and meteorological influences) and internal factors. Mechanical irritants that increase the likelihood of precancerous diseases of the red border of the lips include the habit of holding a pen, pencil or nails in the mouth, as well as some industrial hazards, for example, the presence of a large amount of silicate or iron ore dust in the surrounding atmosphere.
The list of chemical irritants includes spices, tobacco (smoking, chewing) and alcoholic beverages (especially strong). Thermal irritants that provoke a warty precancerous red border of the lips are too hot food and the habit of smoking a cigarette to the end, burning the lips. Meteorological effects are of great importance: wind, dust, sunlight, high humidity at low ambient temperature.
Internal factors contributing to the development of keratinization processes in the lip area are age-related dehydration of epidermal cells, hormonal changes and certain diseases, for example, diabetes mellitus or chronic anemia. Researchers also note that keratinization increases with fever, stress, chronic diseases of the digestive system (gastritis, enteritis, colitis), ichthyosis, psoriasis, systemic lupus erythematosus and xerostomias of various genesis.
Symptoms, diagnosis and treatment of warty precancerous red lip border
Usually the patient goes to the doctor in connection with the appearance of a cosmetic defect. Examination reveals a dense tumor-like formation in the form of a single nodule with a diameter of 4 to 10 mm, usually located on the lower lip in the gap between the corner of the mouth and the median line. The color of the nodule ranges from normal, matching the color of the lip, to purple or dark red. The surface is bumpy, sometimes covered with thin, grayish, hard-to-remove scales. The surrounding tissues are not changed.
The diagnosis of warty precancerous red border of the lips is established on the basis of anamnesis, external examination data and biopsy results. During histological examination, a limited proliferation zone is determined, growing above or below the level of the epithelium, and areas of hyperkeratosis alternating with areas of parakeratosis. Differential diagnosis is carried out with papilloma, keratoacanthoma and wart. The difference between the warty precancer of the red border of the lips from the papilloma is the absence of a soft leg, from the keratoacanthoma of the lips – in the absence of a funnel-shaped depression surrounded by a roller of compacted hyperemic tissues and filled with keratinized cells, from the wart – in the absence of lobulation and papillary growths.
Treatment of warty precancerous red border of the lips is surgical excision within healthy tissues. Without treatment, the prognosis is unfavorable. There is a high probability of malignancy within a few months after the appearance. Malignant degeneration is indicated by rapid growth, germination into nearby tissues, intense keratinization, ulcers, erosion, bleeding or bleeding when feeling.