Actinic cheilitis: proposition and reproducibility of a clinical criterion

Abstract

Objectives/Aims:The actinic cheilitis (AC) is a precancerous lip lesion seen as a consequence of chronic sun exposure. Clinically, the border between the lip’s skin and the semimucosa could be blurred; in the more aggressive cases, leucoplakia and ulcers also represent its clinical feature. It seems that no clinical criterion is universally accepted for this disease yet. Therefore, this study was carried out to make a proposition of a clinical score to actinic cheilitis (Grade I starting from dryness of vermilion to endured ulcers representing Grade IV) and to assess its reproducibility.Materials and Methods:Fifty subjects were assessed, most of whom were male, Caucasian farmers, with an average age of 46.12 (18–74) years. The obtained data were analysed by means of descriptive statistics and by Kappa test to assess the inter-examiners and the clinical Golden-Pattern concordance (95% CI).Results:During calibration, 15 patients were examined three times a week by each examiner (4) until Kappa test observed k=0.8 or more. In the main experiment, the inter-examiner concordance was classified between good (k=0.779; P<0.05) and very good (k=0.925; P<0.05) from the 35 examined subjects. With the Golden-Pattern, it was considered very good (k=0.812; P<0.05 to k=0.925; P<0.05).Discussion:Four examiners with different experiences could strongly suggest that after adequate calibration, it could be well applied by examiners with as much experience as a dental student.Conclusions:The authors concluded that the proposed classification was easily applied and had a very good reproducibility.

Evaluation of effect of a vitamin-based barrier cream on the clinical severity of actinic cheilitis: A preliminary study

“…However, there are several less invasive, easy-to-use, low-cost alternatives that can both prevent and treat AC. This is especially relevant considering as verified in the present study—the potential for progressive remission of severe AC lesions, which pose the highest risk of malignant transformation to SCC ( 21 ).…”

“…Possible limitations of this study include the fact that clinical examination may sometimes underestimate the severity of AC in cases with a less aggressive appearance and varying degrees of undetectable dysplasia. However, this possible confounding factor was minimized by clinical classification of lesion severity, based on well-established criteria ( 21 ). Other limitation, only patients of 43 years or older were include in the study.…”

“…After an interview to collect sociodemographic (gender, age, education level, household income), behavioral (sun exposure, smoking, alcohol intake), and clinical (medical and dental history) variables, participants underwent clinical examination and photographs were obtained with a 720p HDR digital camera (Apple Inc.) at 240fps for evaluation. Using a scheme adapted from Poitevin et al ( 21 ), AC severity was classified as grade I (dryness and/or peeling of the surface of the vermilion of the lips); grade II (atrophy of the vermilion border of the lip with a slightly pale, raised surface and loss of sharpness of the boundary between skin and vermilion border, or presence of a melanotic line); grade III (any of the above, plus presence of rough and scaly areas of hyperkeratosis invading the inner mucosa of the lip); or grade IV (any of the above plus erosion). All procedures were performed by two previously trained examiners.…”

Development of a Photonumeric Lip Health Scale

“…The 3 key lip characteristics-texture, shine, and vermilion border-were selected because of their importance to the appearance attributes of lip health that can be affected by lip products. 12,27,28 For example, healthy lips have a distinct vermilion border. 27,28 In addition, the characteristics were selected because they represent healthy lips and are easily photographable.…”

“…12,27,28 For example, healthy lips have a distinct vermilion border. 27,28 In addition, the characteristics were selected because they represent healthy lips and are easily photographable.…”