Background:
Plasma cell cheilitis (PCC) is a rare, benign inflammatory condition of the lips, characterised by infiltration of plasma cells into the submucosa, often presenting as sore, crusted, or ulcerated lesions. Its clinical appearance can closely resemble squamous cell carcinoma (SCC), posing a diagnostic challenge.
Case:
An 81-year-old male was referred by his GP with a few months history of non-healing, crusted lesions on his lower lips. He’s a non-smoker with occasional alcohol consumption. Initially suspected to be SCC, the patient underwent biopsy and histopathological examination. The initial biopsy was difficult to interpret due to intense inflammation but contained budding of atypical cells felt to amount to early invasive SCC. The lesion underwent wide local excision and primary closure.
Results:
Histopathological findings revealed a dense infiltration of plasma cells in the submucosal tissue, consistent with PCC. The lesion was successfully excised but this alternative diagnosis was only recognised on full histopathological exam. The patient remained symptom-free post op.
Conclusion:
This case emphasises the need for heightened awareness of plasma cell cheilitis as a potential diagnosis in patients presenting with crusted lip lesions, particularly when SCC is suspected. Early recognition and accurate diagnosis of PCC can prevent misdiagnosis, reduce unnecessary invasive procedures, and ensure appropriate management which would usually be steroids first line.