Treatments of actinic cheilitis: A systematic review of the literature

Michela Lai, Riccardo Pampena, Luigi Cornacchia, Giovanni Pellacani, Ketty Peris, Caterina Longo

Research output: Contribution to journalReview article

Abstract

Background: No large studies have defined the best treatment of actinic cheilitis. Methods: We conducted a systematic review to define the best therapies for actinic cheilitis in clinical response and recurrences. Results: We first identified 444 papers, and 49 were finally considered, including 789 patients and 843 treated areas. The following therapies were recorded in order of frequency: laser therapy, photodynamic therapy (PDT), 3% diclofenac in 2.5% hyaluronic acid, PDT + 5% imiquimod, aminolevulinic acid–laser or methyl-aminolevulinic acid–laser, 5% imiquimod, fluorouracil, partial surgery, 0.015% ingenol mebutate, 50% trichloroacetic acid, and laser + PDT. Concerning the primary outcome, complete clinical response was achieved in 76.5% of patients, and 10.2% had clinical recurrences. Partial surgery and laser therapy showed the highest complete response rates (14 of 14 [100%] and 244 of 260 [93.8%], respectively) with low recurrences. Only a limited number of patients were treated with other therapies, with the exception of PDT, with 68.9% complete responses and 12.6% of recurrences. Interestingly, when combined with 5% imiquimod, the efficacy of PDT was significantly enhanced. Limitations: Heterogeneity across studies. Conclusion: Laser therapy appears the best option among nonsurgical approaches for actinic cheilitis, and PDT showed higher efficacy when sequentially combined with 5% imiquimod. Larger studies are needed to confirm these data.

Original languageEnglish
JournalJournal of the American Academy of Dermatology
DOIs
Publication statusE-pub ahead of print - Aug 7 2019

Keywords

  • actinic cheilitis
  • diclofenac
  • imiquimod
  • laser
  • photodynamic therapy
  • treatment

ASJC Scopus subject areas

  • Dermatology

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