Treatment of actinic cheilitis: a systematic review

Clin Oral Investig. 2019 May;23(5):2041-2053. doi: 10.1007/s00784-019-02895-z. Epub 2019 Apr 23.

Abstract

Objectives: Actinic cheilitis is a potentially malignant disorder caused by excessive sun exposure. It affects the lower lip of individuals, mostly those with light skin color. Different treatments have been proposed for AC; however, no consensus has been reached on the best option available.

Materials and methods: The present study describes the results of a computer-based systematic search conducted on electronic databases to identify the best therapies.

Results: A total of 29 journal articles were selected, and the results were divided according to the type of treatment employed: laser therapy, chemotherapy agents, surgical treatment, and application of anti-inflammatory agents. Clinically, photodynamic therapy showed positive results, with improvement in up to 100% of the patients; however, histopathological improvement varied greatly, from 16 to 100%. Among the chemotherapeutic agents assessed, imiquimod showed the best results: clinical improvement in 80 to 100% of the patients, and histopathological improvement in 73 to 100%. Regarding studies describing surgical approaches, the main focus was the search for the best technique, rather than the cure of AC. Finally, studies employing anti-inflammatory agents are sparse and have small samples, thus providing limited results.

Conclusion: The scientific evidence available on the treatment of AC is scarce and heterogeneous, photodynamic therapy, and imiquimod application are promising.

Clinical relevance: The study of the treatments for AC in the form of a systematic review allows us to evaluate the results against the different treatments. Being a potentially malignant lesion, it is important to seek evidence about the best results found.

Keywords: Actinic cheilitis; Imiquimod; Laser; Systematic review; Vermilionectomy.

Publication types

  • Systematic Review

MeSH terms

  • Cheilitis / therapy*
  • Humans
  • Laser Therapy*
  • Lip / pathology
  • Photochemotherapy*

Supplementary concepts

  • Actinic cheilitis