Actinic prurigo of the lip: Two case reports

Abstract

Actinic prurigo is a photodermatosis that can affect the skin, conjunctiva and lips. It is caused by an abnormal reaction to sunlight and is more common in high-altitude living people, mainly in indigenous descendants. The diagnosis of actinic prurigo can be challenging, mainly when lip lesions are the only manifestation, which is not a common clinical presentation. The aim of this article is to report two cases of actinic prurigo showing only lip lesions. The patients were Afro-American and were unaware of possible Indian ancestry. Clinical exam, photographs, videoroscopy examination and biopsy were performed, and the diagnosis of actinic prurigo was established. Topical corticosteroid and lip balm with ultraviolet protection were prescribed with excellent results. The relevance of this report is to show that although some patients may not demonstrate the classical clinical presentation of actinic prurigo, the associated clinical and histological exams are determinants for the correct diagnosis and successful treatment of this disease.

Keywords: Actinic prurigo, Follicular cheilitis, Photodermatosis, High-altitude, Lip diseases

Core tip: The diagnosis of actinic prurigo can be challenging in the absence of classic clinical manifestations. Actinic prurigo is found in high-altitude living people, mainly in indigenous descendants. Disease onset is usually in childhood and rarely presents only on the lips. This study describes two rare cases from Rio de Janeiro city, Brazil, which is located at sea level. The patients were unaware of possible Indian ancestry. Moreover, actinic prurigo appeared in adulthood and lip lesions were the only manifestation. The associated clinical and histological exams are determinants for the correct diagnosis and successful treatment of this disease.