Demographic and Clinicopathologic Features of Actinic Cheilitis and Lip Squamous Cell Carcinoma: a Brazilian Multicentre Study

Silva, Leni Verônica de Oliveira; Arruda, José Alcides Almeida de; Abreu, Lucas Guimarães; Ferreira, Raquel Conceição; Silva, Leorik Pereira da; Pelissari, Cibele; Silva, Ricardo Natã Fonseca; Nóbrega, Kaio Heide Sampaio; Andrade, Bruno Augusto Benevenuto De; Romañach, Mário José; Agostini, Michelle; Nonaka, Cassiano Francisco Weege; Alves, Pollianna Muniz; Pontes, Hélder Antônio Rebelo; Rivero, Luis Fernando; Souza, Lélia Batista de; Trierveiler, Marília; Mendonça, Elismauro Francisco; Gomes, Ana Paula Neutzling; Martins, Manoela Domingues; Andrade, Emanuel Sávio de Souza; Silveira, Márcia Maria Fonseca da; Sobral, Ana Paula Veras; Mesquita, Ricardo Alves

doi:10.1007/s12105-020-01142-2

Cited by 23 publications

(28 citation statements)

References 39 publications

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“…[47] In our study; for both AC and SCC groups, the cases were older than 50 years of age, and the most frequently affected site by SCC was the lower lip (n=18) in accordance with the literature. [7,8,43,48] We determined no significant relationship between expressions of p53, p16 INK4a , p14 ARF and histopathological factors in cases of SCC of the lip, consistent with the study done by Cheng et al [45] There are very few studies investigating the immunohistochemical features of the epithelium adjacent to SCC of the lip. [37,49,50] We observed a positive correlation between p14 ARF and p53 protein expressions in the peritumoral epithelium of SCC cases, but no correlation was observed in AC cases without SCC.…”

Section: Resultssupporting

confidence: 88%

p16 INK4a , and p14 ARF Expressions in Carcinogenesis of Squamous Cell Carcinoma of the Lip

Akatlı¹,

Ayva²,

Bozdoğan³

2022

Clin Cancer Investig J

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The goal of this study was to clarify the role of p16 INK4a , p14 ARF, and p53 protein expressions in carcinogenesis in squamous cell carcinomas of the lip. The expressions of the p53, p16 INK4a , and p14 ARF proteins were examined in 46 formaline-fixed paraffin embedded tissue specimens, which included 19 cases of squamous cell carcinoma of the lip, 14 cases of actinic cheilitis, and 13 cases of normal mucosa. Immunoreactivity in the peritumoral epithelium adjacent to squamous cell carcinomas was also evaluated. p16 INK4a expression was increased in actinic cheilitis in comparison with normal mucosa (p=0.001). p14 ARF expression progressively increased from normal mucosa to actinic cheilitis (p=0.001) and was observed to decrease significantly during the process of transition from actinic cheilitis to carcinoma (p=0.003). p53 values progressively increased from normal mucosa to actinic cheilitis (p=0.001) and carcinoma (p=0.008). A significant positive correlation was found between p14 ARF and p53 in the peritumoral epithelium adjacent to carcinomas. Our findings indicated that p16 INK4a and p14 ARF immunohistochemistry does not determine whether or not actinic cheilitis has the potential to develop carcinoma. The p14 ARF /p53 pathway is activated in the peritumoral epithelium adjacent to carcinoma; however, this activation would not be adequate to prevent carcinogenesis.

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Section: Resultssupporting

confidence: 88%

p16 INK4a , and p14 ARF Expressions in Carcinogenesis of Squamous Cell Carcinoma of the Lip

Akatlı¹,

Ayva²,

Bozdoğan³

2022

Clin Cancer Investig J

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“…The AC may be similar to the classic form of actinic keratosis with well-demarcated, erythematous papules, or plaques with scale; but often there is a diffuse, multifocal, and heterogeneous lesion characterized by xerosis ( Figure 1A ), scales, hyperkeratotic areas ( Figure 1B ), and even atrophy. The atrophy was defined as the depression of the lip that results from the thin epidermis/dermis ( 8 ). At palpation, it feels like sandpaper.…”

Section: Clinical Picturementioning

confidence: 99%

“…At palpation, it feels like sandpaper. The color of the lip can be changed: erythema (explained by vasodilatation), spotting (change of color of the normal mucosa without elevation or depression), a mottled appearance (erythema and white patches) ( Figure 1C ), or brown spots ( 7 , 8 ). The demarcation between the lip and the surrounding skin can be blurred ( Figure 1D ).…”

Section: Clinical Picturementioning

confidence: 99%

“…The demarcation between the lip and the surrounding skin can be blurred ( Figure 1D ). There can be loss of tissue presenting as vertical fissures (linear clefts extending into the dermis) ( Figure 1E ) or ulceration (full thickness loss of the epidermis) ( 8 ). A plaque ( Figure 1F ) can be found (described as a raised, flat lesion, > 1 cm diameter) or the entire lip can be indurated ( 7 , 8 ).…”

Section: Clinical Picturementioning

confidence: 99%

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Actinic Cheilitis — From Risk Factors to Therapy

et al. 2022

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Actinic cheilitis or solar cheilosis is considered a precursor of malignancy or even an in situ squamous cell carcinoma (SCC) of the lip, located most frequently on the lower lip. Actinic cheilitis (AC) has a higher likelihood of developing into invasive SCC of the lip, which is one of the deadliest non-melanoma skin cancers. Risk factors include chronic UV exposure, increasing age, male gender, fair phototypes, chronic scarring, immunosuppressive therapy, and tobacco use. From a clinical point of view, AC is characterized by dryness, scaling, atrophy, indistinct borders, and erosions. Ulceration and the appearance of a nodule often suggest the progression to invasive SCC. Dermoscopic examination reveals white structureless areas, scales, erosions, and white halos of the vermilion. Reflectance confocal microscopy shows disruption of the stratum corneum, parakeratosis, an atypical honeycomb pattern, solar elastosis, and dilated and tortuous blood vessels with increased blood flow. The rate of malignant transformation ranges from 10 to 30% and early diagnoses and treatment are essential in preventing the development of invasive SCC. Optimal treatment has not been established yet, but invasive and topical treatments can be tried. The present paper aims to review the existing data regarding epidemiology, risk factors, clinical picture, non-invasive imaging, diagnosis, and therapy in AC.

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“…Actinic cheilitis (AC) is a premalignant lesion on the lips in patients who are overexposed to sunlight, and it has a significant chance of evolving into invasive squamous cell carcinoma (SCC). It primarily affects the lower lip of male individuals over the age of 50, and its clinical features include dryness, atrophy, scaling, erythema, ulceration, and a poorly demarcated border [1][2][3][4]. Most patients are of the Fitzpatrick I-II skin phototype [3].…”

Section: Introductionmentioning

confidence: 99%

Treatment Options and Post-Treatment Malignant Transformation Rate of Actinic Cheilitis: A Systematic Review

Bakirtzi

Papadimitriou

Andreadis

et al. 2021

Cancers

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Actinic cheilitis is a premalignant condition that may evolve to squamous cell carcinoma. A consensus on its management has not been established, and large clinical trials are lacking. We aimed to review the existing data regarding the treatment of actinic cheilitis with various modalities regarding safety, efficacy, recursions, and post-treatment malignant transformation. A systematic review was conducted through Pubmed, Ovid and the Cochrane library for studies in English language and the references of included papers from inception to January 2021. Case series were considered if ≥6 patients were included. Of the 698 articles, 36 studies and, overall, 699 patients were eventually reviewed. Laser ablation and vermilionectomy provided the best clinical and aesthetic outcomes with few recurrences, while photodynamic therapy was linked to more relapses. Generally, the adverse events were minor and there was no risk of post-treatment malignant transformation. The limitations of our review include the heterogeneity and the small number of patients across studies. Conclusively, invasive treatments demonstrated superior therapeutic and safety profile. Nevertheless, high-quality head-to-head studies that assess different modalities for actinic cheilitis and report patient preferences are lacking.

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Demographic and Clinicopathologic Features of Actinic Cheilitis and Lip Squamous Cell Carcinoma: a Brazilian Multicentre Study

Cited by 23 publications

References 39 publications

p16 INK4a , and p14 ARF Expressions in Carcinogenesis of Squamous Cell Carcinoma of the Lip

p16 INK4a , and p14 ARF Expressions in Carcinogenesis of Squamous Cell Carcinoma of the Lip

Actinic Cheilitis — From Risk Factors to Therapy

Treatment Options and Post-Treatment Malignant Transformation Rate of Actinic Cheilitis: A Systematic Review

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