Actinic Cheilitis

 Full-thickness keratinocytic atypia, often with prominent suprabasilar mitoses and apoptotic figures

• Squamous cell carcinoma (SCC)
image Invasive islands of atypical keratinocytes involving stroma

image Often associated with ulceration and dense inflammatory infiltrate

• Actinic cheilitis prurigo
image Most common in Native Americans, usually presents in summer months after sun exposure

• Contact cheilitis
image Similar to contact dermatitis, with spongiosis and eosinophils

• Plasma cell cheilitis

Clinical Photograph of Actinic Cheilitis
This clinical photograph shows actinic cheilitis (AC) diffusely involving the lower lip with associated crusting image. (Courtesy J. Wu, MD.)

Actinic Cheilitis Histologic Findings
Histologic section of AC shows mucosal acanthosis with overlying parakeratosis. There is irregular budding image and basilar atypia, with many of the cells showing enlarged, hyperchromatic-staining nuclei image.

AC With Prominent Acanthosis
AC with prominent mucosal acanthosis and elongation of the rete ridges is shown. Atypical keratinocytes involve the lower 1/3 of the epithelium, and scattered mitotic figures are easily identified image.

Increased Ki-67 Staining in AC
Immunohistochemistry for Ki-67 shows increased proliferative activity with strong nuclear staining in numerous basilar keratinocytes image.



• Actinic cheilitis (AC)


• Actinic keratosis (AK) of lip

• Solar cheilosis

• Cheilosis exfoliativa


• Proliferation of atypical keratinocytes involving basilar layers of mucosal epithelium

• Minority of cases may transform into squamous cell carcinoma in situ (SCCis) or invasive squamous cell carcinoma (SCC)


Environmental Exposure

• Chronic sun exposure, especially UVB rays

• Smoking and chronic irritation are also risk factors

Infectious Agents

• Herpes virus infection and syphilis implicated in rare cases



Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Actinic Cheilitis

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