Poitevin et al reported a grading scheme for actinic cheilitis (AC, solar cheilosis). This can help to identify a patient who may require more aggressive management. The authors are from Pontifical Catholic University of Rio Grande do Sul and the University of Brazil.

Patient selection: chronic sun exposure with suspected actinic cheilitis (AC)


Clinical Findings

Grade of AC

dryness and desquamation of vermilion of lips


atrophy on the vermilion border; may appear mottled or show eruptions; line demarcating border of vermilion surface with skin may be blurred or show a dark line


rough, squamous areas on the drier parts of the vermilion; hyperkeratotic areas; hyperkeratosis on the lingual aspect of the lips


ulceration; leukoplakia



Reasons to suspect malignancy - Grade IV and one or more of the following:

(1) history of smoking (pipe, cigarette, etc)

(2) persistent area of induration on palpation

(3) nonhealing and enlarging ulcer

To read more or access our algorithms and calculators, please log in or register.