What is Actinic Cheilitis?
Actinic cheilitis is an inflammatory disease of the lips, caused by the presence of increased sensitivity to UV rays. In children, the disease occurs quite often, which is associated with their prolonged exposure to the sun.
Causes of Actinic Cheilitis
This is a chronically pathological pathology that develops due to increased irritability of the skin in the area of the red border of the lips in relation to the sun’s rays.
Symptoms of Actinic Cheilitis
The disease affects middle-aged men – from 30 to 60 years. In accordance with the modern classification, it is customary to distinguish exudative and dry forms of pathology.
The basis of all pathological changes in actinic cheilitis is the development of an allergic reaction to the ultraviolet radiation spectrum. As additional provoking factors in this pathology, various diseases of the digestive system, liver and gallbladder most often act.
Exacerbations of the disease develop in the spring season. When a dry variety of red rim on the lower lip begins to dry out strongly, becomes bright red. Its surface is covered with scales of silver-white color. It is characteristic that the upper lip and generally the upper part of the face are almost never involved in the pathological process. In some of the diseased people, the skin on the red border of the affected lip begins to harden, which is why it acquires a rather distinctive appearance.
The exudative form of actinic cheilitis is nothing but one of the types of acute allergic contact dermatitis with characteristic clinical manifestations of the disease. The red border of the lower lip swells slightly, bright red spots appear on it. In some cases, small bubbles appear on such a background. They quickly open, empty, in place of them remain defects of the red border of the lips. Then they become covered with crusts, which later disappear, and recovery begins.
Coming to the clinic, such patients often make complaints to the doctor about the sensation of burning, itching, pain in the area of pathological formations on the lips. The diagnosis helps in identifying the seasonality of the disease, its long wave-like course. In the spring and summer, there are aggravations, while in the autumn and winter, the signs of the disease go away on their own.
With a very long course of the disease, deeper changes occur in the red border of the lips, which, unlike those appearing during periods of exacerbation, are more permanent. The skin in the area of red border partly horny, becomes more rough. Further deep enough cracks, surface defects and even ulcers appear on it. If these structures do not heal for a long time, in their area there are thickening, growths of the type of warts, then in these cases there is a fairly serious risk of developing cancer of the lower lip. Therefore, all such patients should be taken material from the field of lesions for microscopic examination for the detection of tumor cells.
The dry variety of actinic cheilitis is very similar in its manifestations to the dry form of exfoliative cheilitis, with the result that in some cases diagnostic difficulties arise. The difference is that in the second case, the upper lip is most often affected, while in actinic cheilitis, the lower lip is most often affected.
Diagnosis of Actinic Cheilitis
Sometimes when making a diagnosis of actinic cheilitis, it is necessary to distinguish it from the atopic form of the disease. In this form, pathological foci occupy not only the area of the red border, but also extend to the skin, they almost always come to light in the area of the corners of the mouth.
At the same time, the appearance of rashes is connected not with the stay under the sun, but with the action of any allergens, most often of chemical nature. The greatest difficulties arise in those cases when it is necessary to distinguish actinic cheilitis from contact atopic, since it is in fact a kind of it, although rather peculiar. In such situations invaluable help to the doctor is able to provide a detailed questioning of the patient.
Treatment of Actinic Cheilitis
As with any disease of an allergic nature, with actinic cheilitis, the main and most effective measure is to prevent contact with the allergen as much as possible. All such patients are advised to avoid staying, especially long, under open sunshine.
The main drug treatment for actinic cheilitis is the administration of vitamin therapy. Vitamins of group B, A, E, P, C are prescribed. Sometimes they are combined with antimalarial drugs with adrenal cortex hormones in small dosages. On the skin, topical ointment with drugs of adrenal hormones is given a good effect.
The prognosis for cheilitis is always favorable. It should only be remembered that a dry form with a long existence can eventually lead to the development of cancer of the lower lip.
Prevention of Actinic Cheilitis
If a person knows about his predisposition to this disease (postponed cases, the presence of pathology among relatives), then he should constantly use various light-protective creams and ointments, less be under open sunlight.