Dermoscopic features of lip squamous cell carcinoma and actinic cheilitis: A systematic review and meta-analysis

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.