A case report on Actinic cheilitis: a rarer entity among Sri Lankans

Actinic keratosis (AK) is a dermatological condition commonly found among fair-skinned populations and considered as a potentially malignant disorder usually appearing on sun-exposed areas such as the scalp, face and forearms. It is an uncommon disorder among Asians. Therefore, Actinic Keratosis in Asians has not been thoroughly investigated. AK is clinically termed as“Actinic chelitis” when lesions present in the lips. This case report is about a 42-year-old male who presented at the Oral Medicine Clinic of the University Dental Hospital, Peradeniya, with a complaint of burning sensation of the mouth which aggravates with spicy foods for about three months. Been working in a farm from the age of 12 years and exposure to sunlight for about 9 to 10 hours a day, he has had an extreme exposure to sunlight. Examination revealed an erythematous, non-indurated ulceration of the lower lip. Histopathological sections showed ulcerated mucosa covered by orthokeratinized stratified squamous epithelium with regenerative atypia towards the ulcer bed. Degenerative changes of collagen were evident in the upper corium. The patient was educated about the disease and a protective local covering agent was prescribed to apply on the affected area. This case report emphasizes the possibility of acquiring AK among dark-skinned people due to extreme exposure to sunlight and the importance of knowledge about this disease entity for clinicians when diagnosing as it may have been misdiagnosed.