Recent research has greatly enhanced our understanding of the etiopathogenic
pathways underlying squamous cell carcinoma (SCC) of the skin. The
predominant etiologic agent is ultraviolet radiation. Exposure to
excessive sunlight may lead to the development of sunburn, premature aging of
the skin, cataracts, immune suppression, and skin cancer. Actinic
keratoses represent an early clinical stage of a continuum that may ultimately
progress to become SCC of the skin. Actinic cheiloses represent actinic
keratoses occurring on the lip vermilion.
The highly developed lip vermilion exists only in man and is bounded by the
keratinized skin and mucous membrane of the inner lip.1
The epidermis is characterized by a highly developed stratum lucidum and a very
thin stratum corneum. Hair and sweat glands are absent but dermal papillae
are abundant, leading to the rich vascular supply that imparts the
characteristic red color. In dark-complected individuals, the red hue is
camouflaged by the increased melanin deposits.2
Oral health care providers are in a prime position to identify patients at
risk for actinic cheiloses, educate patients on preventive measures to minimize
the damaging effects of sunlight, and, if necessary, manage early actinic
cheiloses.