Angular cheilitis is characterized by inflammatory lesions presenting in the corner(s) of the mouth. The causes include infection with Candida albicans or Staphylococcus aureus, wearing oral dentures or other devices, anemia, deficiencies in the B vitamins, etc. The diagnosis is achieved by findings on physical exam, a thorough history, and a workup of underlying etiologies.
Angular cheilitis is defined as inflammation of the corner(s) of the mouth . While the cause has not been completely elucidated , the most predominant etiology is infection with Candida albicans (commonly found on dentures) , Staphylococcus aureus (found on face masks), and beta-hemolytic streptococci   . Specifically, this condition may arise from poorly fitting oral dentures , occupational face masks, pacifier use in young children , contact irritation such as with nickel found in orthodontic braces  , excessive salivation  , and thumb sucking and lip licking . Very importantly, angular cheilitis can develop secondary to anemia and deficiency in the B vitamins as well as immunosuppression . It is also one of the oral manifestations in patients with Crohn's disease and may be observed in those with no gastrointestinal involvement   .
This unpleasant condition is characterized by erythematous, scaly, and ulcerating fissures found on the angles of the mouth . These lesions can bleed and cause pain and burning, especially when applying pressure on them . Additionally, the lips are often dry. Successful therapy is essential to prevent further episodes of angular cheilitis .
The inspection yields findings such as cracking, mucosal atrophy, crusting, ulceration, and other signs suggestive of inflammation . The patient may be wearing dentures or have manifestations of the gingival and dental disease .
Entire Body System
Jaw & Teeth
Showing it to your doctor, he would certainly tell you point blank – Angular Cheilitis! This would be followed by you asking, “What is Angular Cheilitis?” To learn specific details of angular cheilitis in an informative video, Click Here. [web.archive.org]
Abstract The purpose of this prospective study was to re-examine the relative importance of various factors in the pathogenesis of angular cheilitis. Sixty-four patients with cheilitis were examined clinically and microbiologically. [ncbi.nlm.nih.gov]
- Cracked Lips
This can be caused by a fungal infection and is characterized by cracked lip corners. [pandagossips.com]
lips O/E - dry lips O/E - dry/cracked lips O/E - lip swelling On examination - angular stomatitis On examination - angular stomatitis (disorder) On examination - cracked lips On examination - cracked lips (finding) On examination - dry lips On examination [averbis.com]
The inflammation can cause pain in the lips, cracked lips, ulceration, reddened skin, and tenderness at the involved area. Typically, both sides of the mouth are involved, but the condition can occur on one side only. [medicinenet.com]
When a person is deficient in vitamin B12, they may experience various oral problems, ranging from cracked lips to tongue inflammation or even ulcers in their mouth. [express.co.uk]
Dilaceration Discoloration Ectopic enamel Enamel hypocalcification Enamel hypoplasia Turner's hypoplasia Enamel pearl Fluorosis Fusion Gemination Hyperdontia Hypodontia Maxillary lateral incisor agenesis Impaction Wisdom tooth impaction Macrodontia Meth mouth Microdontia [en.wikipedia.org]
When infection or eczema is present, topical antibiotics, antifungals, and steroids play a role. [news-medical.net]
Links: eczema/dermatitis oral candidiasis low B12 vitamin B2 deficiency iron deficiency [gpnotebook.com]
According to a 2011 study published in Cutis, angular cheilitis is more common in people who have eczema due to the sensitive nature of their skin (see claim: “Angular cheilitis caused by irritation is especially common in patients with eczema because [tiege.com]
Furthermore, after extensive research for angular cheilitis, I am now almost positive I had angular cheilitis instead of eczema. [healthywildandfree.com]
[…] due to nutritional deficiency states: 5% due to xerostomia (dry mouth): immunosuppressant medications drugs: indinavir sorafenib substance abuse esp. cocaine, methamphetamines, heroin, and hallucinogens other causes: chronic mucocutaneous candidiasis eczema [ozemedicine.com]
[…] paresthesias anywhere in body - tingling, pins and needles, etc (my back, it's directly related to the gas in my intestines) paresthesias in both legs - burning sudden electric like shocks/pains shooting down arms, body, legs shooting down from neck movement clumsiness [forums.phoenixrising.me]
The diagnosis is based on clinical findings and assessment of risk factors. Furthermore, the workup consists of the patient's history, physical exam, and investigation of the etiology.
Very importantly, the clinician must inquire about the onset, duration, previous episodes, and past treatments . In an effort to determine the predisposing factors and underlying cause, the clinician should elicit the patient's dental history, use and fit of dentures or other prostheses, dental hygiene, and other pertinent information  . Additional details regarding any medication use, tobacco smoking/chewing, and alcohol use should be obtained  . Moreover, the patient's medical history should be evaluated for anemia, nutritional deficiencies, immunosuppression, allergic cutaneous conditions, and so forth  .
Swabs of the angles of the mouth and nose are helpful with determining the offending organism. Additionally, samples of the dentures are useful for microbial assessment .
If primary therapy is ineffective, the patient should undergo a thorough workup for anemia and nutritional deficiencies with a complete blood count (CBC), iron studies as well as measurements of vitamins B2, B6, B12, and folate  . Correction of iron deficiency anemia and any vitamin insufficiency will successfully treat the angular cheilitis  .
Clinical assessments including a microbial examination were carried out 8 months and 5 yr after termination of treatment. [ncbi.nlm.nih.gov]
A Balanced Diet Can Help You Defeat Angular Cheilitis Much Faster — angular cheilitis treatment over the counter — more information Angular Cheilitis treatment cracked corners of mouth treatment There are numerous medicines available on the market, which [medium.com]
The overall prognosis of oral candidiasis is good, and rarely is the condition life threatening with invasive or recalcitrant disease. [ncbi.nlm.nih.gov]
The prognosis is very good once the cause (etiology) has been properly treated or eliminated. One should first check for denture loss of vertical dimension and then for a deficiency in riboflavin. [todaysdentist.org]
[…] in length and depth than Type I lesion Type III: Lesion consisting of several rhagades radiating from the corner of the mouth into the adjacent skin Type IV: Lesion presenting no rhagades, but erythema of skin contagious to the vermilion border" Prognosis [statpearls.com]
A significant positive relationship between commissural leukoplakia and an infective etiology of angles was noted. [ncbi.nlm.nih.gov]
Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]
[…] patients with systemic sclerosis]. 61 Selifanova EI...Esayan MS 31322605 2019 17 The prevalence of developmental anomalies among school children in Southern district of Andhra Pradesh, India. 61 Bandaru BK...Rajendra Santosh AB 31110441 2019 18 2016 Epidemiological [malacards.org]
Epidemiology Angular cheilitis (AC) occurs with a prevalence of 0.7% in the general American population, although it can occur more frequently in select groups. It is the most common bacterial/fungal infection of the lips. [statpearls.com]
[…] angular stomatitis EpidemiologyIncidence Most common in 3rd, 5th, and 6th decades of life (1) Present in up to 25% of Down syndrome patients (1) Prevalence 0.7–3.8% of oral lesions in adults (1) 0.2–15.1% of oral lesions in children (1) Etiology and Pathophysiology [unboundmedicine.com]
The basic pathophysiology leading to angular cheilitis is maceration of the skin in the commissures, which disrupts the epidermal barrier. Such disruption provides a breeding environment for fungi and bacteria. [pharmaceutical-journal.com]
Although C albicans can exist harmoniously in the oral cavity, it is thought to contribute to the pathophysiology of angular cheilitis. [dermatologyadvisor.com]
In rare conditions such as orofacial granulomatosis, the incidence is as high as 20%. Pathophysiology Most cases of angular cheilitis (AC) are ultimately due to physical maceration at the angular commissures due to overexposure to saliva. [statpearls.com]
The fact is, with the right kind of food, you can prevent angular cheilitis from coming back. [healthydietbase.com]
Dentures that do not fit properly should be adjusted to prevent lip irritation via friction and to allow the mouth to properly close. This will prevent saliva build-up on the corners of the mouth. [healthy-skincare.com]
In edentulous and immunosuppressed patients, candidiasis may recur very quickly, and preventive therapy consisting of an application of a barrier ointment such as petrolatum, zinc oxide, or use of an imidazole cream q.d. may be necessary to prevent recurrences [derm101.com]
Using cocoa butter daily will prevent your lips from becoming dry and chapped. Apply a dab or two of natural cocoa butter directly on the affected area three times a day every day. [healthyfocus.org]
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