Photodynamic Therapy for Actinic Cheilitis: A Systematic Review

BACKGROUNDActinic cheilitis (AC) is a premalignant lesion of the lips that can progress to squamous cell carcinoma and metastasize. Actinic cheilitis is difficult to treat because surgical treatments have significant adverse effects whereas less invasive procedures have uncertain efficacy. Photodynamic therapy (PDT) may offer a noninvasive yet effective treatment option for AC.OBJECTIVETo systematically review the safety and efficacy of PDT for AC.METHODSThe terms photodynamic, actinic, solar, cheilitis, and cheilosis were used in combinations to search the PubMed database. Studies were considered for inclusion based on eligibility criteria, and specific data were extracted from all studies.RESULTSThe authors identified 15 eligible case series encompassing a total of 242 treated subjects. Among studies that evaluated subjects for complete clinical response, 139 of 223 subjects (62%) showed complete response at final follow-ups ranging from 3 to 30 months. Among studies that evaluated subjects for histological outcome, 57 of 121 subjects (47%) demonstrated histological cure at final follow-ups ranging from 1.5 to 18 months. Cosmetic outcomes were good to excellent in the majority of subjects, and adverse events were well tolerated.CONCLUSIONPhotodynamic therapy is safe and has the potential to clinically and histologically treat AC, with a need for future randomized controlled trials.