UVR-induced damage to the lip may be acute, resulting in sunburn, blistering or peeling; chronic exposure leads to SC, primarily of the lower lip.1,2,12,21,22,31 In its early stages, SC presents as a dry, scaly unobtrusive “chapped lip.” Palpation provides a sense of rubbing the fingers over sandpaper.32 At later stages small nodules; marked parallel fissuring; mottled, opalescent white or gray plaques; erosion or ulceration along with crusting; as well as loss of definition of the lip vermilion are noted.1,32-34
The clinical appearance of SC does not always correlate directly with underlying histological changes and an apparently suspicious lesion may prove to be benign, while a perceived benign lesion may in fact represent severe dysplasia or even SCC.1 Waxing and waning of erythematous or ulcerative areas with evidence of induration and pain are ominous signs.35,36 Figures 1-8 document the progression of labial UVR damage from acute sunburn to primary and recurrent invasive SCC.
Blistering secondary to acute exposure to UVR.
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