Juan Seoane1, Saman Warnakulasuriya2, José Vicente Bagán3, José Manuel Aguirre-Urizar4, Pía López-Jornet5, Gonzalo Hernández-Vallejo6, Miguel Ángel González-Moles7, Manuel Pereiro-Ferreiros8, Javier Seoane-Romero9, Pablo Varela-Centelles1,10. 1. Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, (A Coruña), Spain. 2. Emeritus Professor, King's College London, WHO Collaborating Centre for Oral Cancer, London, UK. 3. Oral Medicine, Valencia University, Valencia, Spain. 4. Department of Stomatology, University of Basque Country/EHU, Spain. 5. Department of Oral Medicine, University of Murcia, Hospital Morales Meseguer, Murcia, Spain. 6. Department of Clinical Dental Specialities, Complutense University of Madrid, Madrid, Spain. 7. Oral Medicine, School of Dentistry, University of Granada, Granada, Spain. 8. Department of Dermatology, University of Santiago de Compostela (A Coruña), Spain. 9. USC International School of Doctorate, Ciudad Real University Hospital, Ciudad Real, Spain. 10. CS Praza do Ferrol. EOXI Lugo, Galician Health Service, Lugo, Spain.
Abstract
AIMS: to discuss the terminology to define and classify actinic cheilitis (AC); and to build a consensus on the diagnostic and therapeutic approaches to AC. METHODS: Two-round Delphi study using a questionnaire including 34 closed sentences (9 on terminology and taxonomy, 5 on potential for malignant transformation, 12 on diagnostic aspects, 8 on treatment) and 8 open questions. Experts' agreement was rated using a Likert scale (1-7). RESULTS: A consensus was reached on 24 out 34 statements (73.5%) and on 5 out of 8 (62.5%) close-ended questions. The response rate was identical in both rounds (attrition of 0%). AC is the term with the highest agreement (median of 7 (strongly agree; IQR: 6-7) and the lowest dispersion (VC=21.33). "Potentially malignant disorder" was the preferred classification group for AC (median of 7) and 85.6% of participants showing some level of agreement (CV<50). Experts (66.75%) consider AC a clinical term (median: 7; IQR: 4-7) and believe definitive diagnosis can be made clinically (median: 6; IQR: 5-7), particularly by inspection and palpation (median: 5; IQR: 4-6). Histopathological confirmation is mandatory for the management of AC (median: 5; IQR: 2.5-7), even for homogeneous lesions (median: 5; IQR: 3.5-6). Consensus was reached on all treatment statements (VC<50). CONCLUSIONS: AC is a potentially malignant disorder with a significant lack of agreement on diagnostic criteria, procedures, biopsy indications, and the importance of techniques to assist in biopsy. A consensus was reached on nomenclature and management of this disorder. This article is protected by copyright. All rights reserved.
AIMS: to discuss the terminology to define and classify actinic cheilitis (AC); and to build a consensus on the diagnostic and therapeutic approaches to AC. METHODS: Two-round Delphi study using a questionnaire including 34 closed sentences (9 on terminology and taxonomy, 5 on potential for malignant transformation, 12 on diagnostic aspects, 8 on treatment) and 8 open questions. Experts' agreement was rated using a Likert scale (1-7). RESULTS: A consensus was reached on 24 out 34 statements (73.5%) and on 5 out of 8 (62.5%) close-ended questions. The response rate was identical in both rounds (attrition of 0%). AC is the term with the highest agreement (median of 7 (strongly agree; IQR: 6-7) and the lowest dispersion (VC=21.33). "Potentially malignant disorder" was the preferred classification group for AC (median of 7) and 85.6% of participants showing some level of agreement (CV<50). Experts (66.75%) consider AC a clinical term (median: 7; IQR: 4-7) and believe definitive diagnosis can be made clinically (median: 6; IQR: 5-7), particularly by inspection and palpation (median: 5; IQR: 4-6). Histopathological confirmation is mandatory for the management of AC (median: 5; IQR: 2.5-7), even for homogeneous lesions (median: 5; IQR: 3.5-6). Consensus was reached on all treatment statements (VC<50). CONCLUSIONS: AC is a potentially malignant disorder with a significant lack of agreement on diagnostic criteria, procedures, biopsy indications, and the importance of techniques to assist in biopsy. A consensus was reached on nomenclature and management of this disorder. This article is protected by copyright. All rights reserved.