Actinic cheilitis: Do stem cells have a role in its management? A case series

Actinic cheilitis (AC) is a premalignant mucosal lip condition that mainly affects the lower lip and has a high propensity of malignant transformation into squamous cell carcinoma. There is no gold standard for its management, but early intervention aims to minimise the risk of malignant transformation. Here we report our experience of utilising nanofat grafting in the management of AC. Retrospective data analysis was carried out between 2020 and 2024. Patients diagnosed with AC were treated with nanofat grafting. The nanofat preparation was harvested from the abdomen and prepared using the PureGraft® filtration system (Bimini Health Tech), and was infiltrated into the lips in two layers. Outcomes were assessed clinically. Seven patients were included in our analysis with a mean follow up of 23 months. All patients had had previous treatment for AC such as topical 5-fluororacil, steroids, laser ablation, and cryotherapy. Five of the seven received simultaneous nanofat grafting followed by erbium laser resurfacing at the same appointment. The others had nanofat grafting after laser resurfacing. Following the procedure all the patients had no further cracks, ulcerations, or erosions of the lips, with a good definition of the vermilion border, and all patients remained symptom free. The combination of nanofat grafting and laser resurfacing provides an alternative minimally invasive solution for patients with persistent AC. We have formulated an algorithm for management based on our experience.