Acta Dermato-Venereologica 98-10CompleteContent | Page 13

970 CLINICAL REPORT Actinic Cheilitis Prevalence and Risk Factors: A Cross-sectional, Multicentre Study in a Population Aged 45 Years and Over in North-west Spain Isabel RODRÍGUEZ-BLANCO 1,2 , Ángeles FLÓREZ 3 , Carmen PAREDES-SUÁREZ 4 , Romina RODRÍGUEZ-LOJO 5 , Daniel GONZÁLEZ-VILAS 6 , Aquilina RAMÍREZ-SANTOS 7 , Sabela PARADELA 8 , Ignacio SUÁREZ CONDE 9 and Manuel PEREIRO- FERREIRÓS 2 Departments of Dermatology: 1 Hospital da Barbanza, University Hospital, 2 University of Santiago de Compostela, Santiago de Compostela, 3 University Hospital, Pontevedra, 4 Hospital Virxe da Xunqueira, University Hospital, La Coruña, 5 University Hospital, Lucus Augusti, 6 University Hospital, Vigo, 7 University Hospital, Santiago de Compostela, 8 University Hospital, La Coruña, and 9 University Hospital, Ourense, Spain Actinic cheilitis is thought to be a premalignant lesion or a superficial squamous cell carcinoma. The preva- lence of actinic cheilitis in Europe is unknown. The aim of this study was to determine the prevalence of ac- tinic cheilitis in the Galicia region (north-west Spain). Secondary objectives were the description of risk fac- tors of actinic cheilitis. A cross-sectional multicentre study in patients ≥ 45 years of age was performed in 8 dermatology departments in Galicia region during a 1-year period. The prevalence of actinic cheilitis was 31.3%. Significant and independent risk factors of ac- tinic cheilitis after multivariate analysis were age ≥ 60 years, Fitzpatrick skin phototype II, outdoor working for more than 25 years, and previous history of non- melanoma skin cancer. This is the first cross-sectional multicentre study of the prevalence of actinic cheilitis in Europe. Actinic cheilitis was present in almost one- third of the screened patients. Lip examination should be performed in all patients with chronic actinic da- mage. Key words: actinic cheilitis; prevalence; epidemiology. Accepted Aug 7, 2018; Epub ahead of print Aug 7, 2018 Acta Derm Venereol 2018; 98: 970–974. Corr: Isabel Rodríguez-Blanco, Dermatology Department, Hospital da Barbanza-Hospital Gil Casares, C/Choupana s/n, ES-15706, Santiago de Compostela (La Coruña), Spain. E-mail: [email protected] A ctinic cheilitis (AC) is the most common denomina- tion for a condition with clinical and histological changes due to chronic solar exposure, mainly involving the lower lip (1). Similarly to actinic keratosis (AK) of the skin, AC is considered to be a potentially malignant oral lesion (2) or even a lip in situ squamous cell carcinoma (SCC) (1, 3, 4). Diagnosis and treatment of AC can be challenging; it has been shown that the clinical appearance of AC correlates poorly with the degree of dysplasia (5–9), thus clinicians have little evidence about the severity of the disease. The accuracy of diagnosis can be increased with new imaging techniques, such as dermoscopy, with the presence in AC of ill-demarcated borders, vascular telangiectasia, white-coloured projections and island-like structures around the ulcerous areas (10), or confocal mi- doi: 10.2340/00015555-3014 Acta Derm Venereol 2018; 98: 970–974 SIGNIFICANCE Actinic cheilitis is a condition involving mainly the lower lip that is generally considered a superficial form of squamous cell carcinoma. Chronic sun exposure is a recognized risk factor for actinic cheilitis development. The prevalence of this disease  in Europe is not known. We report  the first multicenter prevalence study of actinic cheilitis. The di- sease was present in almost one third of the screened population  ≥45 years. Significant and independent risk factors were age ≥60 years, fair skin (Fitzpatrick skin pho- totype II), outdoor working for more than 25 years and history of non melanoma skin cancer. croscopy (11). Performing a biopsy is mandatory in cases of doubtful lesions. Furthermore, the response to therapy is commonly unsatisfactory, with frequent recurrences. There have been few epidemiological studies of AC compared with those related to AK; prevalence data of AC proceed from heterogeneous epidemiological studies performed in specific populations, mainly in South Ame- rica (12–25), thus the prevalence in Europe has not been established, since multicentre, well-designed prevalence studies have not been performed. The rate of progression of AC to an invasive SCC is unknown. Since the lip has traditionally been considered a high-risk location for SCC, knowledge of risk factors is of great importance. The main objective of the present study was to deter- mine the prevalence of AC in the Galicia region of Spain. Secondary objectives were: (i) to describe risk factors for AC in our study population; and (ii) to establish the clinical and epidemiological profile of patients with AC. METHODS A cross-sectional multicentre study was conducted in Galicia (total population in 2016: 2,718,525; data from Galician Statistics Institute, http:www.ige.eu), a region located in north-west Spain. Consecutive patients attending a general dermatology outpatient clinic were recruited once a week from 12 January 2016 to 31 January 2017, by 8 dermatology consultants, located in 8 different hospitals. Only patients ≥ 45 years of age attending as a “First Visit”, who signed the informed consent were included. A “First Visit” was defined as: (i) a patient who was seen for the first time This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2018 Acta Dermato-Venereologica.