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Dentistry · Oral medicine and oral cancer: actinic cheilitis
Sample itemA 62-year-old farmer has a scaly, atrophic lower lip with loss of the sharp line between vermilion and skin and a small non-healing crust. Which condition is this, and what is its main cause?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Actinic cheilitis due to chronic ultraviolet exposure
Actinic cheilitis is a potentially malignant change of the lower lip vermilion caused by long-term sun exposure. It shows dryness, scaling, atrophy and blurring of the vermilion border and may progress to squamous cell carcinoma. Sun protection and biopsy of any ulcer or induration are advised.
Option by option
A. Cheilitis glandularis due to minor salivary hyperplasia
Cheilitis glandularis shows enlarged, inflamed minor gland openings with mucus secretion.
B. Exfoliative cheilitis due to lip-licking habit
Exfoliative cheilitis shows persistent peeling of keratin and does not blur the border in this way.
C. Actinic cheilitis due to chronic ultraviolet exposure (correct)
Correct. Chronic solar damage of the lower lip is a premalignant condition.
D. Angular cheilitis due to candidal infection
Angular cheilitis affects the corners of the mouth, not the whole vermilion.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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