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
Further Reading All Angular Cheilitis Content What is Angular Cheilitis? What is the difference between Angular Cheilitis and Herpes Simplex type 1? Last Updated: May 23, 2019 Written by Dr. Liji Thomas Dr. [news-medical.net]
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]
Angular cheilitis Other names Rhagades, perlèche, cheilosis, angular cheilosis, commissural cheilitis, angular stomatitis Bilateral angular cheilitis in an elderly individual with false teeth, iron deficiency anemia and dry mouth Pronunciation [en.wikipedia.org]
Abstract The incidence of recurrence of angular cheilitis following a successful antimicrobial treatment was studied in 48 patients. [ncbi.nlm.nih.gov]
- Cracked Lips
Dry lips or cracked lips sometimes have dry and flaky skin on the entire lip but sometimes only the lip corners get dry and cracked. [pandagossips.com]
lips|On examination - cracked lips (finding)|On examination - dry lips|On examination - dry lips (disorder)|On examination - dry/cracked lips|On examination - dry/cracked lips (disorder)|On examination - lip swelling|On examination - lip swelling (finding [averbis.com]
Other angular cheilitis symptoms and signs Chapped Lips Cracked Lips Drooling Dry Mouth Fissured Lips Lip Pain Lip Tenderness Lip Ulceration Reddened Lips Reddened Skin SLIDESHOW Top Problems in Your Mouth See Slideshow Pictures, Images, Illustrations [medicinenet.com]
If a person notices cracked lips on both sides of their mouth it could mean they’re deficient in vitamin B12. DON’T MISS People who experience this condition will have dry, red lips that crack on one or both sides of their mouth. [express.co.uk]
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. [rxlist.com]
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]
Furthermore, after extensive research for angular cheilitis, I am now almost positive I had angular cheilitis instead of eczema. [healthywildandfree.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]
[…] 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]
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  .
Treatment Angular cheilitis is sometimes a self-limited condition and then the treatment consists of symptomatic management. [news-medical.net]
A Balanced Diet Can Help You Defeat Angular Cheilitis Much Faster — angular cheilitis treatment over the counter http://bit.ly/2L5IGY4 — more information Angular Cheilitis treatment cracked corners of mouth treatment There are numerous medicines available [medium.com]
Clinical assessments including a microbial examination were carried out 8 months and 5 yr after termination of treatment. [ncbi.nlm.nih.gov]
Consult a trusted medical or treatment professional to further assist you in making treatment choices. Natural Treatments According to Earth Clinic, some of the best ways to treat angular cheilitis are natural. [epicraze.com]
Due to its bacteria killing abilities, virgin coconut oil is also a great preventative treatment. Apply coconut oil four times a day to the infected areas. 4) Cocoa Butter Cocoa butter is another great moisturizing natural treatment. [healthyfocus.org]
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]
[…] lesions may resolve when the underlying disease is treated, e.g. with a course of oral iron or B vitamin supplements. Patch testing is recommended by some in cases which are resistant to treatment and where allergic contact dermatitis is suspected. Prognosis [en.wikipedia.org]
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. [symptoma.com]
A significant positive relationship between commissural leukoplakia and an infective etiology of angles was noted. [ncbi.nlm.nih.gov]
Treatment of Angular Cheilitis or Stomatitis: Due to its varied Etiology unless the primary cause is corrected the infection is not primarily cured. [juniordentist.com]
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]
[…] cheilitis respond quickly when antifungal treatment is used. In more long standing cases, the severity of the condition often follows a relapsing and remitting course over time. The condition can be difficult to treat and can be prolonged. Epidemiology [en.wikipedia.org]
[…] 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]
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]
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]
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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