Dermoscopic features of lip squamous cell carcinoma and actinic cheilitis: A systematic review and meta‐analysis
Isabelle Albuquerque Reis, Lilia Maria Lima de Oliveira, Fátima Maria Thaiz da Fonte Gomes da Silva, Lyria de Oliveira Rosa, Gabrielle de Lacerda Dantas Henrique, Nathália Freire Borba, Larissa Calixto Hespanhol, Heloísa Carneiro Brito, João Vitor Andrade Fernandes, Beatriz Ximenes Mendes, Naiara Abreu Fraga‐Braghiroli
Abstract
Lip squamous cell carcinoma (SCC) accounts for approximately 30% of oral malignancies. Delayed diagnosis worsens the prognosis, leading to tumor growth, regional lymph node involvement, distant metastasis, and the need for invasive therapy. Dermoscopy is a practical, low‐cost, and non‐invasive diagnostic tool used to detect skin tumors. This review analyzed the common dermoscopic features of lip SCC and actinic cheilitis (AC). A search of MEDLINE, EMBASE, and Web of Science was made for original dermatoscopy studies. Pooled proportions were calculated using a random‐effects model (95% CI). Eleven studies were included: 325 patients, 205 lip SCCs, and 122 ACs. Key dermoscopic findings in lip SCCs were white structureless areas 61.9%, ulceration 59.3%, white halos 57.7%, keratin scales 54.98%, pinkish‐red background 50.5%, whitish‐yellow colors 41.8%, and shiny white streaks 24.5%. Polymorphous vessels were found in 55.8%, and monomorphous in 44.1%. Vessel morphology was hairpin 30.90%, serpentine 22.27%, dotted 21.46%, and glomerular 11.20%. ACs exhibited white halos in 66.14% of cases, white structureless areas in 59.62%, white scales in 57.90%, yellow scales in 30.14%, ulceration in 32.43%, white circles in 9.94%, and had polymorphous (72.93%), hairpin (30.83%), or dotted (20.71%) vessels. Dermoscopy aids early detection of lip SCC and AC, though overlapping features can limit accurate distinction. Histopathological confirmation remains essential in difficult cases, and further studies should explore subgroup‐specific dermoscopic patterns.
Make this part of your paper trail
Save this paper to a shelf, write a review, and keep your own notes.
Community Ratings
★5(1 rating)
5
★★★★★
1 rating
5
1
4
0
3
0
2
0
1
0
Community Reviews
Lyria Rosa
12/21/2025
This review underlines how dermoscopy can support earlier recognition of lip SCC and AC, two conditions where delays in diagnosis can significantly impact outcomes. Lip SCC makes up a substantial portion of oral cancers, and the progression from premalignant lesions like AC to invasive disease is a real clinical concern, so improving early, non-invasive detection really matters. As one of the authors and a dermoscopy enthusiast, I can say that the value of this paper lies in the systematic compilation of dermoscopic patterns that are actually observed in clinical practice. Features such as white, structureless areas, ulceration, white halos, and polymorphous vessels were consistently observed in lip SCC, while AC showed some overlapping but distinct trends. Illustrating those patterns makes the overlap and the subtle differences between SCC and AC easier to grasp. Overall, the review supports dermoscopy as a practical tool that can raise suspicion earlier and guide clinical decisions, especially in limited settings. At the same time, it appropriately emphasizes that histopathology remains essential in challenging cases and that more refined dermoscopic data could further improve diagnostic accuracy in the future.