First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Dermatology, School of Medicine, University of Chile, Santiago, Chile.
J Eur Acad Dermatol Venereol. 2022 Feb;36(2):222-227. doi: 10.1111/jdv.17790. Epub 2021 Nov 17.
Squamous cell carcinoma of the lip accounts for 20% of all oral carcinomas. Its diagnosis may be challenging because it clinically resembles actinic cheilitis and inflammatory lesions of the lips.
To determine clinical and dermatoscopic predictors of squamous cell carcinoma of the lip vs. other lip lesions.
Multicentre retrospective morphological study, including histologically confirmed cases of squamous cell carcinoma of the lip and controls consisting of actinic cheilitis and inflammatory lesions of the lips. Clinical and dermatoscopic images were evaluated for the presence of predefined criteria. Crude and adjusted odds ratios and corresponding 95% confidence intervals were calculated by univariate and multivariate logistic regression respectively.
A total of 177 lip lesions were evaluated, 107 (60.5%) were squamous cell carcinomas and 70 (39.5%) were controls. The most frequent dermatoscopic criteria of lip squamous cell carcinoma were scales (100%), white halos (87.3%) and ulceration (79.4%). The majority of squamous cell carcinomas displayed polymorphic vessels (60.8%), with linear (68.6%) and hairpin (67.6%) being the most frequent types. Multivariate logistic regression analysis showed that clinical predictors of lip squamous cell carcinoma were exophytic appearance and clinical hyperkeratosis, with 43-fold and 6-fold higher probability respectively. White clods and ulceration in dermoscopy presented a 6-fold and 4-fold increased risk for squamous cell carcinoma respectively.
A scaly lesion with exophytic growth, dermatoscopically displaying white clods, ulceration and linear and hairpin vessels is very likely a squamous cell carcinoma of the lip.
唇鳞状细胞癌占所有口腔癌的 20%。由于其临床表现类似于光化性唇炎和唇部炎症性病变，因此诊断可能具有挑战性。
确定唇鳞状细胞癌与其他唇病变相比的临床和皮肤镜预测因素。
多中心回顾性形态学研究，包括组织学证实的唇鳞状细胞癌病例和对照组，包括光化性唇炎和唇部炎症性病变。评估临床和皮肤镜图像是否存在预设标准。通过单变量和多变量逻辑回归分别计算粗比值比和调整比值比及其相应的 95%置信区间。
共评估了 177 个唇病变，其中 107 个（60.5%）为鳞状细胞癌，70 个（39.5%）为对照组。唇鳞状细胞癌最常见的皮肤镜标准为鳞屑（100%）、白色晕环（87.3%）和溃疡（79.4%）。大多数鳞状细胞癌显示多形性血管（60.8%），其中线性（68.6%）和发夹（67.6%）最为常见。多变量逻辑回归分析显示，唇鳞状细胞癌的临床预测因素为外生性外观和临床角化过度，其发生的概率分别增加了 43 倍和 6 倍。皮肤镜下的白色结块和溃疡使鳞状细胞癌的风险分别增加了 6 倍和 4 倍。
具有外生性生长、皮肤镜下显示白色结块、溃疡以及线性和发夹状血管的鳞屑性病变极有可能是唇鳞状细胞癌。
