Chronic exposure to the sun can result in solar damage to the lips, especially in high-risk individuals. Over time this can progress to dysplasia and eventually squamous cell carcinoma.
Risk factors:
(1) long-term occupational or recreational exposure to sun (farmer, fisherman, beach worker, etc)
(2) photosensitivity
(3) hereditary defects in skin pigmentation (albinism, other)
(4) tobacco and/or alcohol use
(5) light-skin color
Clinical manifestations:
(1) The actinic damage tends to affect the lower lip more than the upper, with involvement of the vermilion surface.
(2) Initially there is erythema and desquamation followed by hyperkeratosis and fissuring.
(3) With time ulceration and/or mass lesions may appear.
Biopsy of the affected lip shows actinic damage with solar elastosis, hyperkeratois, parakeratosis and epithelial dysplasia. As dysplasia progresses squamous cell carcinoma may develop.
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