Actinic Cheilitis
David Cassarino, MD, PhD
Key Facts
Terminology
Actinic cheilitis (AC)
Actinic keratosis of lip
Etiology/Pathogenesis
Chronic sun exposure, especially UVB rays
Clinical Issues
Excellent in most cases, low risk of developing SCCis and invasive SCC
Microscopic Pathology
Mucosa may be hyperplastic or atrophic
Basilar keratinocytic atypia with budding
Increased mitotic activity typically present in basilar layers
Top Differential Diagnoses
Squamous cell carcinoma in situ (Bowen disease)
Squamous cell carcinoma (SCC)
Actinic cheilitis prurigo
 Clinical photograph shows actinic cheilitis diffusely involving the lower lip with associated crusting  . (Courtesy J. Wu, MD.) |
 Histologic section of actinic cheilitis shows mucosal acanthosis with overlying parakeratosis. There is irregular budding  and basilar atypia, with the cells showing enlarged, hyperchromatic-staining nuclei  . |
TERMINOLOGY
Abbreviations
Actinic cheilitis (AC)
Synonyms
Actinic keratosis (AK) of lip
Solar cheilosis
Cheilosis exfoliativa
Definitions
Proliferation of atypical keratinocytes involving basilar layers of mucosal epithelium
Minority of cases may transform into squamous cell carcinoma in situ (SCCis) or invasive SCC
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