Hvad er Actinic Cheilitis (AC)?


Hvad er aktinisk cheilitis
Aktinisk cheilitis manifesterer en diffus eller pletvis tørhed og variabel fortykkelse af vermillion af den nedre læbe. Den fremherskende form for aktinisk cheilitis skyldes kronisk solen. Det kaldes også aktinisk cheilosis, sol cheilitis og undertiden, aktinisk cheilitis med histologisk atypi.
AC næsten altid påvirker de lavere læber og kun sjældent overlæben, sandsynligvis på grund af underlæben mere udsat for solen. I de sjældne tilfælde rapporteret hvor det påvirker overlæben, dette kan skyldes øvre læbe prominente Commissurer (mundvigene er normalt ikke involveret.
Berørte personer kan opleve symptomer som tør fornemmelse og krakning af læberne. Det er normalt smertefri og vedholdende.
Udseendet er variabel. Hvid læsion indikerer hyperkeratose Rød, eroderende eller ulcerøse læsioner indikerer tab af epitel og inflammation. Tidlig, den akutte læsion kan være erytematøs (rød) og ødematøs (opsvulmet) måneder og år af sol eksponering, lektionen bliver kronisk og kan være grå-hvid og ser tørt, skællende og rynket.

Hvorfor har jeg Tørre og sprukne læber?

Der tænker hvidlig misfarvning af læben ved grænsen af ​​læben og huden. Der er fortykkelse hvidlig plet af læben på kanten af ​​munden og huden. Der er også et fald i den normalt skarpe grænse mellem den røde af læben og ham normal hud, kendt som vermillion grænse. Dette kan blive skællet og hærdet som AC fortsætter.

Når gnide din hånd mod læben, du måske bemærke læben har en tekstur der ligner gnide behandskede finger langs sandpapir.

AC may occur with skin lesions of actinic keratosis or skin cancer else particularly on the head he neck since these are the most sun-exposed areas. Rarely it may represent a genetic susceptibility to light damage (e.g., xeroderma pigmentosum or actinic prurigo).

Årsager
AC is created by chronic and excessive exposure to ultraviolet radiation in sunlight Risk factors include:

Outdoor lifestyle: e.g., farmers, fishers, windsurfers, mountaineers, golfers. This has given rise to synonyms for this condition such as sailor’s lip and farmer’s lip. There is a prevalence of agricultural workers in a semi-arid region of Brazil who report AC in some areas as high as 16.7%
Light skin complexion: the condition typically affects people with lighter skin tones. Partially Caucasian living in tropical regions. IN one report, 96% or person with AC had phenotype 11 according to the Fitzpatrick scale.
Alder: AC commonly affects older individuals, and rarely those under 45 år gammel.
Gender. The condition affects males more commonly than females; Sometimes this ratio is reported as high as 10:1

Actinic cheilitis also describes lip improvement in actinic prurigo, a rare form of photosensitivity.

Who gets actinic cheilitis
Actinic cheilitis largely influences adults with fair skin who live in tropical or subtropical areas, especially outdoors workes. They frequently recall having sunburned lips in earlier years. They may also have actinic keratoses on other sun-exposed sites of the scalp, ører, face, og hænder.
Aktinisk cheilitis er tre gange mere hos mænd end hos kvinder.
Hvad er årsagen til aktinisk cheilitis?
Aktinisk cheilitis skyldes kronisk eksponering af underlæben til solens ultraviolette stråler Det er mere sårbare end omfattende hud, fordi slimhindeepitel er tyndere og mindre pigmenteret end epidermis.
Hvad er de kliniske symptomer på aktinisk cheilitis?
Aktinisk cheilitis mest almindeligt påvirker den nederste læbe (90%), og årsager:

  1. hud Tørhed
  2. Tyndet skrøbelig hud
  3. fortykket, skællende papler og plaques (aktinisk keratose)
  4. Less common symptoms of actinic cheilitis include;
  5. rødme
  6. Soreness
  7. hævelse
  8. Fissuring, focal ulceration, and cutting
  9. White thickened patches (leukokeratosis)
  10. Loss of demarcation/Marks and lipline between the vermillion border of the lip and its adjoining skin
  11. Discoloured skin with pale or yellow area
  12. IIf applying lipstick, which tends tobleed into the surrounding lines
  13. Prominent folds and lip lines.

What is the complication of actinic cheilitis?
Actinic cheilitis is a pre-malignant condition. It predisposes to:

intraepidermal carinoma (Bowen sygdom eller squamoous celle carinoma in situ) .
Invasiv pladecellecarcinom
Kræft i læbe er mere hos rygere end hos ikke-rygere. Andre faktorer omfatter onkogene human papillomavirus (vorte virus), immunosuppression og alkoholmisbrug.

Invasiv skælos celle karcinom bør mistænkes, hvis læben er fokalt bud, eller en vedvarende sår eller forøge knude udvikler.

Hvordan aktinisk cheilitis diagnosticeret?
Aktinisk cheilitis er generelt diagnosticeres klinisk; a skin biopsy may require fluorouracil if skin cancer or an inflammatory cause of cheilitis is presumed.

The pathological characteristics of actinic cheilitis are mutable thickening or atrophy of the lip, partial thickness epidermal dysplasia, solar elastosis and inflammation in the dermis of the skin.

What is the therapy and treatment options for actinic cheilitis?
Smoking for an extended period, and lifelong, year-round, daily sun protection are essential.
Limit sun exposure
Wear a hat with a wide brim
Påfør solcreme-holdige læbepomade hyppigt

Mænd kan overveje at dyrke en overskæg.
Lokale behandlinger for aktinisk cheilitis er ikke godkendt. De omfatter:

Fotodynamisk terapi -Photodynamic terapi (PDT) er en behandling, der bruger et lægemiddel, henvist til en fotosensibilisator eller fotosensibiliserende middel, og en distinkt type lys. Når fotosensibilisatorer afsløres til en specifik bølgelængde af lys, de producerer en form for oxygen, der dræber nærliggende celler.

Hver fotosensibilisator aktiveres af lys med en specifik bølgelængde. This wavelength defines how far the light can travel into the body. Thus, physicians use specific photosensitizers and wavelengths of light to treat different areas of the body with PDT.

Imiquimod cream (Aldara) is an immune response modifier that has been analyzed for the treatment of actinic cheilitis. It develops an immune response in the skin leading to apoptosis (death) or the tumor cells. It produces the epidermis to be invaded by macrophages, which leads to epidermal erosion. T-cells are also stimulated as a consequence of imiquimod treatment. Imiquimod seems to promote animmune memorythat decreases the recurrence of lesions; There is minimal scarring. Complete clearance has been shown in up to 45% of patients with actinic keratoses. Imidlertid, the dose and duration of therapy as well as the long-term efficacy, still need to be established for the treatment of actinic cheilitis.

5-fluorouracil cream Topical 5-fluorotic (5-FU, Efudex, Carac) has been shown to be an efficient therapy for diffuse, but minor actinic cheilitis, 5-fluorouracil works by blocking DNA synthesis. Cells that are quickly growing require additional DNA, so they accumulate more 5-fluorouracil, ending in their death. Healthy skin is much less affected. The treatment normally takes 2-4 weeks based on the response. The expected response includes a swelling phase, followed by redness, oozing, brænding, and finally erosion. Treatment is discontinued when ulceration and crusting develop. There is minimum scarring Complete clearance has been reported in about 50% af patienter.
Aktuel retinoider

Physical call treatment for actinic cheilitis include:

  • kryoterapi
  • Electrocautery
  • Laser ablation, e.g., with Er: YAG laser
  • Vermilionectomy (Surgical removal of the external lip)

How can actinic cheilitis be prevented?
Actinic cheilitis can be avoided by protecting the lips from sun exposure. IN smokers, the risk of cancer can be reduced by smoking cessation.