Surgical versus non‐surgical treatment of actinic cheilitis: A systematic review and meta‐analysis

Carvalho, Marianne de Vasconcelos; Moraes, Sandra Lúcia Dantas de; Lemos, Caa; Júnior, Joel Ferreira Santiago; Vasconcelos, Belmiro Cavalcanti do Egito; Pellizzer, Eduardo Piza

doi:10.1111/odi.12916

Cited by 34 publications

(32 citation statements)

References 45 publications

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“…A broad variety of therapeutic measures are available for AC including cryotherapy, electrodesiccation, carbon dioxide or Er:YAG laser ablation, trichloroacetic acid chemical peel, surgical excision (vermilionectomy), 5-fluorouracil, imiquimod, ingenol mebutate, diclofenac 3% gel with hyaluronic acid 2.5% and photodynamic therapy. 3,6 A recent review analysed the outcome of surgical (n = 122) vs. non-surgical (n = 161) treatments in 283 patients with AC who were included in 10 studies. Remission and recurrence rates were 92.8% and 8.4% in patients who received surgical treatment and 65.9% and 19.2% in patients who received non-surgical interventions, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Remission and recurrence rates were 92.8% and 8.4% in patients who received surgical treatment and 65.9% and 19.2% in patients who received non-surgical interventions, respectively. 3 However, these findings were challenged due to the small number of included patients, lacking assessment of bias risk and the fact that all but one study had a low level of evidence. 12 In conventional PDT, the topical photosensitizer (5-aminolevulinic acid or methyl aminolevulinate) is applied under an occlusive foil.…”

Section: Discussionmentioning

confidence: 99%

“…2 The risk of transformation into SCC of the lips was estimated to be 10-30%, 2,3 and 95% of all SCC of the lips originate from AC. 3 In a retrospective study, over 10 years on AC in 65 patients, 11 patients (16.9%) already had SCC at the initial examination, and in two patients (3.2%), AC progressed into SCC over a period of 2.4 and 2.8 years, respectively. 1 The anatomical location and the biological characteristics of the vermilion (thin, lightly keratinized epithelium with little melanin and fewer secretion from sebaceous and sweat glands) render the lips sensitive to damage by solar radiation.…”

Section: Introductionmentioning

confidence: 99%

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5‐Aminolevulinic acid patch (Alacare) photodynamic therapy for actinic cheilitis: data from a prospective 12‐month follow‐up study on 21 patients

Radaković

Dangl²,

Tanew

2020

Acad Dermatol Venereol

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Background Actinic cheilitis (AC) is a variant of actinic keratosis (AK) affecting the lips and caused by chronic ultraviolet exposure. Objective Alacare is a self‐adhesive, skin‐coloured 5‐aminolaevulinic acid patch that has been developed for use in photodynamic therapy (PDT) of mild‐to‐moderate AK. Based on promising preliminary results in the treatment of AC with Alacare patch PDT, we decided to extend our previous investigation to gain more data on the efficacy, tolerability, safety and cosmetic outcome of Alacare patch PDT for AC. Methods Twenty‐one patients with a clinical diagnosis of mild‐to‐moderate AC were included in the study and subjected to one single session of PDT. After occlusion with the Alacare patch for 4 h, the AC lesions were illuminated for 10 min with red light at a dose of 37 J/cm2. All patients received local anaesthesia prior to illumination. Additionally, all lesions were cooled during PDT with a cold air blower. PDT‐induced pain and skin phototoxicity were monitored during and up to 7 days after PDT. Clinical assessment of efficacy, cosmetic outcome and global patient satisfaction was performed at 3, 6 and 12 months after treatment. Results Nineteen patients completed the study. Three months after PDT, 17 patients (89.5%) had achieved complete remission. Of these, one patient presented with recurrence of AC at the 6‐month follow‐up, whereas all other patients remained in remission until the end of the observation period. The complete clinical cure rate at 1 year after a single Alacare patch PDT thus was 84.2%. Pain during illumination and the phototoxic skin reaction were in general mild to moderate. The cosmetic outcome was excellent. Conclusion The present prospective study on Alacare patch PDT for AC confirms its high clinical efficacy, good tolerability and favourable cosmetic effects. Alacare patch PDT should be considered as a valid treatment option for patients with AC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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5‐Aminolevulinic acid patch (Alacare) photodynamic therapy for actinic cheilitis: data from a prospective 12‐month follow‐up study on 21 patients

Radaković

Dangl²,

Tanew

2020

Acad Dermatol Venereol

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“…The non-surgical approach is less invasive and has fewer secondary effects. But contrarily, in a systematic review by Carvalho et al [34], the surgical treatment was found to be more favorable than non-surgical for AC. However, it is very important to protect lips from sunlight.…”

Section: Actinic Chellitismentioning

confidence: 91%

Oral Mucosal Trauma and Injuries

Koray¹,

Tosun²

2019

Trauma in Dentistry

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Trauma-related oral lesions are common in clinical practice of dentistry and they can impair patients' normal oral function and cause pain in patients' eating, chewing, and talking. An injury to the oral mucosa can result from physical, chemical, or thermal trauma. Such injuries can result from accidental tooth bite, hard food, sharp edges of the teeth, hot food, or excessive tooth brushing. Some injuries can also be caused by iatrogenic damage during dental treatment or other procedures related to oral cavity. In this chapter, oral mucosal trauma and injuries will be examined in four subclasses: physical and mechanical traumas of oral mucosa; chemical injuries of the oral mucosa; radiation injuries; and electrical, thermal burns.

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“…Surgery treatment options include cryosurgery, electrosurgery, laser vaporization and scalpel vermilionectomy. In a systematic review conducted by Vasconcelos Carvalho et al remission rate and recurrence rate of actinic cheilitis were higher and lower respectively for surgical treatment compared to non surgical treatment [6]. Cheilitis granulomatosa (of Miescher) is a rare, painless and idiophatic swelling of the lip belonging to the larger group of orofacial granulomatosis caused by non-caseating granulomatous inflammation.…”

mentioning

confidence: 99%