title: Actinic Prurigo Cheilitis: A Clinicopathologic Review of 75 Cases.
abstract: Actinic prurigo (AP) is a chronic idiopathic photodermatosis that primarily affects American Indians in the United States and Mestizos in Latin American countries. Clinically, the onset of the disease is usually in the first decade of life but may appear initially in adult life, and it is characterized by symmetric involvement of sun-exposed areas of the skin, particularly areas of the face, resulting in polymorphic erythematous papules, macules, and plaques in different stages of evolution. Lower lip involvement includes swelling, scaling, fissures, hyperpigmentation, and ulcerations of the vermilion border. and in some cases could represent the only manifestation of the disease. The histopathologic features of AP have been studied; however, there is a controversy regarding whether AP cheilitis has distinct histopathologic features that could allow accurate separation from other specific and nonspecific forms of cheilitis. The diagnosis can be challenging, mainly when lip lesions are the only manifestation of the disease. In this study, the authors investigate the clinicopathologic features of 75 cases of AP cheilitis to provide further criteria for its diagnosis and classification. All 75 patients presented with lip lesions. Thirty-three cases were diagnosed as AP cheilitis with cutaneous lesions and 42 cases were diagnosed as AP cheilitis without cutaneous lesions (only lip lesions). Histologically, of the 33 cases with AP cheilitis with cutaneous lesions, 17 (52%) cases showed follicular cheilitis, and of the 42 cases that had only lip lesions, 18 (43%) cases showed follicular cheilitis. Histologically, AP cheilitis can present as follicular cheilitis; thus, supporting the diagnosis. Also, our findings confirm that lip lesions can present as the only manifestation of the disease, showing typical histological and clinical features. This form of cheilitis has not being well described in the dermatologic and dermatopathologic literature.
authors.affiliation: *Department of Pathology, Division of Dermatopathology, Medical College of Wisconsin, Milwaukee, WI; †Hospital General Dr. Manuel Gea Gonzalez, Mexico City, Mexico; Departments of ‡Pathology, and §Dermatology, MD Anderson Cancer Center, Houston TX; ¶Hospital General De Mexico, Mexico City, Mexico; ‖Division of Dermatology and Pathology, Hospital Obrero, La Paz, Bolivia; and **Department of Pathology, Dental School, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Plaza
authors.forename: Sonia
authors.initials: S
authors.lastname: Toussaint
authors.forename: Victor G
authors.initials: VG
authors.lastname: Prieto
authors.forename: Patricia
authors.initials: P
authors.lastname: Mercadillo
authors.forename: Juan C
authors.initials: JC
authors.lastname: Diez de Medina
authors.forename: Silvia
authors.initials: S
authors.lastname: Lourenco
authors.forename: Bjorn
authors.initials: B
authors.lastname: Batdorf
authors.forename: Martin
authors.initials: M
authors.lastname: Sangueza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002613:Cheilitis / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010787:Photosensitivity Disorders / Q000473:pathology*; D012873:Skin Diseases, Genetic / Q000473:pathology*; D055815:Young Adult