Actinic prurigo-associated cheilitis of the lower lip: a case report with clinicopathological correlation and management

Actinic prurigo (AP) is a rare, chronic photodermatoses with a challenging diagnosis, particularly when labial involvement represents the sole clinical manifestation of the disease. This study reports a case of a 66-year-old patient presenting with an ulcerated and crusted lesion on the lower lip with a 20-year history, initially clinically diagnosed as actinic cheilitis. A biopsy was performed, and histopathological analysis revealed stratified squamous epithelium with acanthosis and spongiosis, underlying connective tissue with a dense chronic inflammatory infiltrate, and well-organized lymphoid follicles, establishing the diagnosis of cheilitis associated with actinic prurigo. Management consisted of strict photoprotection associated with adjunctive topical corticosteroid therapy (dexamethasone). Six-month postoperative follow-up demonstrated complete remission of local clinical signs and symptoms. This report highlights the relevance of clinicopathological correlation and supports the effectiveness of localized therapeutic approaches in predominantly labial manifestations of actinic prurigo.