Treatments of actinic cheilitis: A systematic review of the literature.

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.

journal_name

J Am Acad Dermatol

authors

Lai M,Pampena R,Cornacchia L,Pellacani G,Peris K,Longo C

doi

10.1016/j.jaad.2019.07.106

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

876-887

issue

3

eissn

0190-9622

issn

1097-6787

pii

S0190-9622(19)32501-0

journal_volume

83

pub_type

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