Assembling a consensus on actinic cheilitis. A Delphi study.

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.