Prevalence of lip lesions in an Indian population

Lip Lumps Need not be mucocele

Lip lesions are the most common oral mucosal lesions. Mucocele is the second most common benign soft tissue masses of the lips only next to infectious etiology. Tumors of the minor salivary glands of the lip were a rare diagnosis made clinically. Excision and histopathological examination must be done for all the lip lumps as this remains the gold standard for the diagnosis. In this article, we discuss three lip lumps which were clinically suspected as mucocoele turned out to be an unexpected diagnosis which only became clear following excision and histological examination.

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Tumors of the labial mucosa: a retrospective study of 1045 biopsies

BACKGROUND

To investigate the relative frequency of localized mucosal swellings of the upper and lower labial mucosa, the clinical-pathological diagnosis agreement and whether patient's age and gender and tumor's site and size may raise the suspicion of neoplasm.

MATERIAL AND METHODS

Retrospective analysis was performed on upper or lower labial mucosal tumors, histopathologically diagnosed between 2009-2018. The diagnostic categories developmental/reactive tumors, benign and malignant neoplasms were associated with patient's age and gender and tumor's site and size; clinical-pathological diagnosis agreement was, also, evaluated.

RESULTS

Overall, 1000 (95.7%) developmental/reactive tumors, 35 (3.3%) benign and 10 (1%) malignant neoplasms were found. Upper/lower lip tumor ratio was 0.14:1. The diagnostic category was significantly associated with age (p<0.0001), site (p<0.0001) and diameter (p<0.0001). Age ≥60 years, tumor's location on the upper lip and diameter >1cm were independent predictors for neoplasms. Patients presenting 2 or 3 of these variables were 20.2 times (p < 0.0001) or 33.6 times (p < 0.0001), respectively, more likely to have a neoplasm. Complete/partial agreement between clinical and pathological diagnosis was seen in 96.3% of the cases.

CONCLUSIONS

Most lip tumors involve the lower lip and are reactive, but upper lip tumors measuring >1cm in patients≥60 years have significantly higher probability to be neoplasms.

A retrospective 11-year study on lip lesions attended at an oral diagnostic service

Background

The objective of this study was to describe the upper and lower lip lesion occurrence in an oral diagnostic service.

Material and Methods

Retrospective descriptive sectional study was performed. Clinical records were obtained from the archives of an Oral Diagnostic Service referral center between 2006 and 2016. Data such as gender, age, anatomical location, and diagnosis were collected and categorized. The collected data were submitted to a descriptive analysis and Pearson's chi-square test (p ≤ 0.05).

Results

A total of 587 patient records of lip lesions were analyzed. Most lesions were diagnosed in female (52.1%) and adults (56.9%) patients in the lower lip (76.2%). Among all lip lesions, the reactive/inflammatory lesions (n = 238; 40.5%) and oral potentially malignant disorders (n = 164; 28%) were the most frequent group lesions. Mucocele (n = 147; 25%), actinic cheilitis (n = 136; 23.1%) and vascular lesions (n = 51; 8.7%) were the most frequent lesion in the sample. Actinic cheilitis was significant in relation to gender (p < 0.001), all three most frequent lesions were significant in concerning to age group and anatomical site.

Conclusions

Mucocele was the most common lower lip lesion in all age groups, followed by actinic cheilitis and vascular lesions, which mainly affected adults and the elderly.

Key words:Lip, lip lesions, oral diseases, epidemiology.

Spectrum of Lip Lesions in a Tertiary Care Hospital: An Epidemiological Study of 3009 Indian Patients

Aim:

Large-scale population-based screening studies have identified lip lesions to be the most common oral mucosal lesions; however, few studies have been carried out to estimate the prevalence of lip lesions exclusively. The aim of present study is to highlight the diversity of lip lesions and determine their prevalence in an unbiased Indian population.

Materials and Methods:

Lip lesions were selected from 3009 patients who visited the department over a period of 3 years (January 2012 to December 2014). Age, sex, location of lip lesions, a detailed family and medical history, along with the history of any associated habit was recorded. Biopsy was carried out in necessary cases to reach a final diagnosis. The pathologies of the lip were classified based on the etiology.

Results:

Among 3009 patients, 495 (16.5%) had lip lesions ranging from 4 years to 85 years with a mean age of 39.7 years. There were 309 (62.4%) males and 185 (31.9%) females. Lower lip was the most affected region (54.1%) followed by the corner of the mouth (30.9%) and upper lip (11.7%). In 3.2% of the cases, both the lips were involved. Of the 495 lip lesions, the most common were Potentially Malignant Disorders (PMDs) (37.4%), herpes labialis (33.7%), mucocele (6.7%), angular cheilitis (6.1%), and allergic and immunologic lesions (5.7%).

Conclusion:

Lip lesions may act as an indicator for the presence of an underlying systemic disease. PMDs and infections were the most common lip lesions in the present study.

Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

The aim of this study was to assess the accuracy of clinical diagnosis for lip lesions based on sensitivity and specificity. The retrospective analysis focused on the detection of lesions caused by potentially malignant disorders (PMDs) and malignant lesions (n = 1195). All cases were classified as benign, PMD, and malignant lesions. Concordance between diagnoses based on clinical examination and those based on histopathological analysis was assessed, and accuracy for the identification of PMD and malignant lesions was calculated. Histopathological analysis revealed 44 lesion types; PMD and malignant lesions comprised 8.3% of all cases. Compared with histopathological analysis, clinical examination showed 97.4% accuracy for the identification of non-malignant and potentially malignant/malignant cases. Degrees of specific sensitivity ranged from 34% to 77% for different lesions, and were highest for autoimmune (77%) and reactive (72%) lesions. Positive and negative predictive values for the identification of PMD and malignant lesions were 81.9% and 98.9%, respectively. Clinical examination showed a high degree of accuracy for the detection of PMD and malignant lip lesions, indicating good reliability.

"Rare or Underdiagnosed?" - Solitary Circumscribed Neuroma of the Lip

Solitary circumscribed neuroma, also known as palisaded encapsulated neuroma is a benign neural tissue tumour. This is usually an asymptomatic and often misdiagnosed pathology in the head and neck region. Lip lesions have a broad differential diagnosis. Clinician's awareness and accurate diagnosis are vital for their appropriate management. Here, we present a case report of solitary circumscribed neuroma of the lip, with a one year follow-up.