Squamous Cell Carcinoma of Lower Lip: Topical Podophyllin is an Alternative Therapy for Early Cases

Background: Although surgical excision is the first line of management for squamous carcinoma of lip, patients with early cases without regional lymphadenopathy or distant metastasis refuse surgical intervention and topical therapy should be looked for. The aim of study: Is to analyze the demographic and clinical features and treatment modalities with follow up findings. Patients and methods: Thirty-six cases of biopsy proved primary SCC of the lower lip from the Dermatology Center, Baghdad Medical City, Baghdad, Iraq during the period from January 2006 to April 2019 were included. Twenty-nine patients were considered for surgical management including electric cautery, while seven patients were treated with Podophyllin (25%) weekly sessions for six weeks with follow up of one year. Results: The male-female ratio was 5:1. The mean age was 54.1±17.9 years. Nearly all of them were skin type III and IV. Single nodular vegetating ulcerative lesion was the feature present in 33 patients, while three patients showed, diffuse lower lip involvement simulating Cheilitis. None had regional lymphadenopathy or distant metastasis. Twelve patients had signs of photoaging. Six patients had risk factors like actinic and oral Lichen planus, Porphyria and solar facial Porokeratosis. No recurrence in patients treated with Podophyllin. Conclusion: Squamous carcinoma of lower lip is disease of middle age males that commonly present with single nodular vegetating ulcerative lesions with no local lymphadenopathy or distant metastases. Topical Podophyllin 25% solution should be kept as alternative for early cases especially those who refuse surgical intervention.