UVR-induced damage to the lip may be acute, resulting in sunburn, blistering or peeling; chronic exposure leads to SC, primarily of the lower lip.1,2,12,21,22,36 In its early stages, SC presents as a dry, scaly unobtrusive “chapped lip.” Palpation provides a sense of rubbing the fingers over sandpaper.37 At later stages small nodules; marked parallel fissuring; mottled, opalescent white or gray plaques; erosion or ulceration along with crusting; as well as loss of definition of the lip vermilion are noted.1,22,38
The clinical appearance of SC does not always correlate directly with underlying histological changes and an apparently suspicious lesion may prove to be benign, while a perceived benign lesion may in fact represent severe dysplasia or even SCC.1 Waxing and waning of erythematous or ulcerative areas with evidence of induration and pain are ominous signs.21,39 Figures 1-8 document the progression of labial UVR damage from acute sunburn to primary and recurrent invasive SCC.
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