Autofluorescence Imaging and Methylene Blue-Mediated Photodynamic Therapy for Early Detection and Management of Subclinical Actinic Cheilitis.

OBJECTIVES: Optical autofluorescence imaging is a noninvasive adjunct for detecting potentially malignant oral disorders, such as actinic cheilitis (AC). This study evaluated its use for early detection and for monitoring tissue response following methylene blue-mediated photodynamic therapy (MB-PDT). METHODS: Lip autofluorescence was assessed using a handheld device (405 ± 20 nm). Areas with altered fluorescence underwent biopsy for confirmation. Patients with AC received five MB-PDT sessions (660 nm, 100 mW, 120 s/point) after topical 1% MB. Grayscale intensity was quantified before treatment and at 30 days. RESULTS: Of 25 screened individuals, 19 had confirmed AC, and 17 completed follow-up. Lesions showed higher fluorescence intensity than healthy tissue. After MB-PDT, mean intensity and variability significantly decreased, indicating tissue response. Smokers showed a smaller reduction. CONCLUSION: Autofluorescence imaging enables early detection and noninvasive monitoring of AC. Combined with MB-PDT, it represents a practical strategy for managing high-risk patients and supporting early intervention.