Actinic Cheilitis — MFDS Part 1 MCQ

Correct answer: D — Lower lip vermilion — cumulative solar ultraviolet exposure

The correct answer is D. Actinic cheilitis is an oral potentially malignant disorder caused principally by cumulative solar ultraviolet exposure. It predominantly involves the lower lip vermilion, which receives greater direct sunlight exposure than the upper lip. Typical features include persistent dryness, scaling, atrophy and loss or blurring of the vermilion border; the patient’s fair complexion and prolonged outdoor occupation strengthen the diagnosis. The upper lip is affected much less commonly, and recurrent herpes produces episodic vesiculation or ulceration rather than diffuse chronic actinic change. The buccal mucosa, floor of the mouth and hard palate are intraoral sites and are not characteristic locations for ultraviolet-induced cheilitis, although trauma, tobacco and alcohol, or thermal injury may cause other lesions at those sites.

Reference: Vasilovici A, et al. Actinic Cheilitis—From Risk Factors to Therapy. Frontiers in Medicine. 2022;9:805425. https://pubmed.ncbi.nlm.nih.gov/35242781/