Diagnostic neglect of actinic cheilitis: a clinical challenge in the early diagnosis of this oral potentially malignant disorder - case report.

BACKGROUND

Lip squamous cell carcinoma (LSCC) is a malignant neoplasm frequently associated with chronic sun exposure. Oral potentially malignant disorders (OPMDs), including actinic cheilitis (AC), might act as a precursor of LSCC. However, AC are often neglected by undertrained clinicians in oral medicine, which delays clinical and histopathological diagnosis and compromises secondary prevention of oral cancer.

CASE REPORT: After a routine clinical oral examination in a 58-year-old male, who was in a follow-up consultation to check on a denture that was installed last year in another service, blurring of the vermilion border between the lip and perioral skin, rough and dry areas, and a single, focal, well-circumscribed leukoplakic plaque on the left lower lip was observed. AC was considered the main diagnostic hypothesis. An incisional biopsy was performed, and histopathological analysis revealed acanthosis hyperkeratosis and mild oral epithelial dysplasia. Clinical and pathological correlation confirmed the diagnosis of AC.

CONCLUSION

This case reinforces that early recognition and prevention are essential to reduce the morbidity associated with AC and LSCC.