Clinical Analysis of Lip Skin Diseases / 대한피부과학회지

BACKGROUND: Lip skin diseases are common findings in dermatology. However, most dermatologists are not familiar with the clinical features of lip skin diseases due to the special characteristics of the lip. OBJECTIVE: This study aimed to evaluate the clinical and histopathological features of lip skin diseases. METHODS: We retrospectively reviewed 259 patients who underwent biopsy for labial diseases at the Department of Dermatology from January 2002 to December 2011. We compared the clinical and histopathological diagnoses and analyzed the rate of concurrence and labial tumor distribution. In addition, demographic and clinical features, including age, sex, location, and disease duration, were investigated. RESULTS: The mean age of the patients was 56.8 years and the male-to-female ratio was 1:0.77. Lip skin diseases accounted for 4.1% of all new patients during the study period, with the lower lip being the most commonly affected site (88.4%). The most common disease was actinic cheilitis (35.1%), followed by chronic cheilitis (11.6%), mucocele (10.0%), and squamous cell carcinoma (9.7%). The most common type of tumor was actinic cheilitis (54.8%), followed by mucocele (15.7%), squamous cell carcinoma (15.1%), hemangioma (4.2%), pyogenic granuloma (4.2%), keratoacanthoma (1.8%), and basal cell carcinoma (1.2%). Before the patients came to the university hospital, they received medical treatment at various clinics and departments, including dermatology clinics (55.3%), internal medicine (26.2%) and urology departments (10.7%), and general practitioners (9.7%). CONCLUSION: This study provides novel and useful data on the incidence and characteristics of lip skin diseases. Compared to previous studies, the frequency of lip tumors was relatively high and variable in this study. Based on these results, we advise physicians to, if in doubt, initially diagnose and treat for actinic cheilitis and labial tumors (especially squamous cell carcinoma) caused by long term exposure to the sun.

Clinical and Histopathological Analysis of Inflammatory Lesions on the Lips / 대한피부과학회지

BACKGROUND: Inflammatory labial lesions are quite common in dermatology. However, a few studies have been performed regarding the clinical and histopathological findings of inflammatory labial diseases. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological features of inflammatory labial diseases. METHODS: We retrospectively reviewed the data of 48 patients who underwent biopsy for inflammatory labial lesions between June 2005 and December 2012. Clinical features and histopathological findings of the lesions were investigated, and they were compared to each other for differential diagnosis. RESULTS: The most frequent inflammatory labial diseases were actinic cheilitis (25%), oral lichen planus (23%), plasma cell cheilitis (23%), oral lichenoid lesion (17%), and eczema (12%). Most of the labial lesions were located on the lower lip (87%). We found a broad overlap in the clinical features of lesions with each other, and in many cases, clinical impressions were inconsistent with their final diagnosis. Histopathologically, the degree of eosinophilic infiltrates in actinic cheilitis was comparable to those in eczema. Oral lichen planus showed orthokeratotic hyperkeratosis rather than parakeratosis, and oral lichenoid lesion displayed more frequent perivascular and deep inflammatory cell infiltrates than oral lichen planus. CONCLUSION: The diagnosis of inflammatory labial diseases may be challenging, because inflammatory labial diseases often show similar clinical features and have a broad overlap in histological features. Therefore, clinico-pathologic correlation is necessary to confirm the diagnosis and for proper management.

Clinical and Histopathologic Analysis of Labial Diseases in Korea / 대한피부과학회지

BACKGROUND: Labial diseases are common in dermatology. However, few studies have reported the clinical and histopathologic features of labial diseases in Korea. OBJECTIVE: This study was designed to investigate the clinical and histopathologic features of labial diseases. METHODS: We retrospectively reviewed 242 patients who received biopsy for labial diseases between January 2005 and May 2010. We compared clinical and histopahtologic diagnoses and analyzed the rate of concurrence. In addition, clinical features, including age, sex, and location, associated cutaneous lesions of 11 major labial diseases, which were confirmed by histopathology, were investigated. RESULTS: The mean age of the patients was 52.2 years. The male to female ratio was 1:1.5. Lower lip was the most commonly involved (77.4%). The most frequent final diagnosis was venous lake, followed by nonspecific inflammation, labial melanotic macule, plasma cell cheilitis, postinflammatory hyperpigmentation, squamous cell carcinoma, lichen planus, mucocele, Fordyce's disease, pyogenic granuloma, and actinic cheilits. Venous lake showed the highest match rate (86.3%), whereas cheilitis simplex exhibited the lowest match rate (0.0%). We also analyzed the clinical features of 11 major labial diseases. The majority of labial diseases occurred in old patients, except for mucocele, Fordyce's disease, or labial melanotic macule. Most diseases occurred predominantly in females, whereas squamous cell carcinoma, plasma cell cheilits, and Fordyce's disease were male-dominant. The most commonly involved location was the lower lip, except for Fordyce's disease. Associated skin lesions, such as ulcers, hyperkeratosis, or whitish patches, were observed in squamous cell carcinoma, plasma cell cheilitis, actinic cheilitis, and lichen planus. CONCLUSION: Compared to previous studies, the actual frequency of actinic cheilitis and squamous cell carcinoma was relatively lower while that of plasma cell cheilitis was relatively higher. We suggest that actinic cheilitis and squamous cell carcinoma are less frequently confirmed than previously expected and that plasma cell cheilitis should be included in the differential diagnosis of labial lesions, especially when they are located on the lower lip and occur in old patients.

A Clinical Study on The Labial Diseases / 대한피부과학회지

BACKGROUND: Diseases of the lips are common, however the clinical investigations of the labial lesions are not sufficient. OBJECTIVE: The purpose of this study was to investigate the epidemiological aspects of the labial diseases with the brief review of the common labial diseases. METHODS: We retrospectively reviewed the data on 117 patients biopsied for the labial lesions at Sanggye Paik Hospital between August, 1989 and May, 2003. RESULTS: The ratio of male to female was 1: 1.54(46: 71). The general age distribution was relatively even, however the age distribution was quite different in each disease. The frequent labial diseases were mucocele, pyogenic granuloma, actinic cheilitis, Fordyce's condition, hemangioma, squamous cell carcinoma, verruca, venous lake, etc., in order of frequency. Vascular disorders and the diseases associated with ultraviolet radiation, such as actinic cheilitis and squamous cell carcinoma, are relatively frequent. Among 117 cases, 29 cases(24.8%), 78 cases(66.7%), and 9 cases(7.7%) involved upper lip, lower lip, and both lips, respectively. And the frequency of the diseases varied according to the locations. CONCLUSION: The result of our study was different from others and we consider the discrepancy resulted from the regional and racial difference. Further investigations of a wider and larger nature are necessary to understand the epidemiology of labial diseases.