Clinical signs: an ill-defined, crusted indurated patch on the right side of the lower lip, adjacent to the angle of the mouth. The rest of the upper and lower lip looks unaffected.

We can also see that this patient is also likely to have skin type I. He is fair with red beard hair. Given that he has an outdoor job, he has a high risk of sun damage.

  

Differential diagnoses:

SCC

BCC

Actinic chelitis

 

Diagnosis

The histology report is consistent with actinic chelitis.

This is due to chronic sun exposure and those with Skin type 1 are at higher risk. It is more severe in smokers. It is important to take a biopsy to exclude an invasive malignancy.

  

Treatment options:

Topical therapies: 5-FU, Imiquimod, Ingenuol mebutate (Picato gel)

PDT

Cryotherapy

Vermillionectomy -  if there is extensive lip involvement 

Last modified: Thursday, 6 July 2017, 12:18 PM