angular cheilitis

Angular cheilitis is an inflammatory condition that causes red, swollen patches in the corners of the mouth where the lips meet and make an angle. It can be associated with a fungal (candidal) or bacterial infection, and can become infected if left untreated. The symptoms include pain and inflammation in the affected area, which can lead to skin breakdown and crusting.

Common Signs and Symptoms of Angular Cheilitis

Angular cheilitis, also known as perleche, is a common condition that affects the corners of the mouth. The main signs and symptoms to look out for include:

• Irritation and soreness in the corner(s) of your mouth
• Bleeding or blistering at one or both corners of the mouth
• Redness and swelling at the affected area
• Cracked or fissured skin at the corners of the mouth
• Dryness, cracking, or sores at the corners of the mouth

These symptoms can be caused by a variety of factors, including:

• Vitamin deficiencies (e.g., vitamin B2, iron)
• Skin conditions (e.g., eczema, psoriasis)
• Hormonal changes
• Allergies or sensitivities to certain foods or substances
• Poor oral hygiene or gum disease

It's essential to seek medical attention if you experience any of these symptoms, as angular cheilitis can be a sign of an underlying condition that requires treatment.

References:

• [1] Mar 16, 2023 — The main things you'll notice are irritation and soreness in the corner(s) of your mouth.
• [2] Angular cheilitis is a common, non-contagious, inflammatory condition affecting the corners of the mouth or oral commissures.
• [5] Angular cheilitis (AC) is inflammation — including redness, swelling, fissures, cracks, crust-like film — and pain at one or both of the commissures.
• [6] Feb 28, 2024 — This inflammation starts off as a patch of dry, red or cracked skin in one or both corners of the mouth.
• [7] Sep 1, 2024 — The symptoms of angular cheilitis include dryness, cracking, swelling, redness, and sores at the corners of the mouth.

Diagnostic Tests for Angular Cheilitis

Angular cheilitis, also known as angular stomatitis or perleche, can be diagnosed through a combination of physical examination and laboratory tests.

• Physical Examination: A thorough examination of the mouth, skin, and other mucosae is required to diagnose angular cheilitis. This includes checking for cracks, redness, swelling, or crusting in the corners of the mouth [4].
• Complete Blood Count (CBC): If concerned about a nutritional deficiency, your doctor may order a CBC to check for any abnormalities in blood cell counts [3].
• Reticulocyte Count: This test measures the number of young red blood cells and can help diagnose anemia or other blood disorders [3].
• Iron, B2, B9, B12, and Zinc Tests: These tests can help identify any nutritional deficiencies that may be contributing to angular cheilitis [3].
• Culture Swabs: Your doctor may take culture swabs from your mouth to check for fungal or bacterial infections [6].
• Lip Biopsy: In some cases, a lip biopsy may be indicated to rule out specific granulomatous diseases that predispose to lip enlargement and to aid in establishing a definitive diagnosis [9].

It's worth noting that diagnosis is often based on physical examination alone, and no special tests are required. Treatment is aimed at keeping the labial commissures dry and free of inflammation [7].

Treatment Options for Angular Cheilitis

Angular cheilitis can be treated using various medications and ointments, depending on the underlying cause of the condition.

• Topical Antifungals: If a fungal infection is causing the angular cheilitis, topical antifungal creams such as nystatin, clotrimazole, or econazole are effective in clearing the infection and preventing future occurrences [1][2].
• Antibiotics: For bacterial infections, antibiotics may be prescribed either orally or topically to treat the condition [3].
• Petroleum Jelly: Applying petroleum jelly on the inflamed areas can help alleviate symptoms if the angular cheilitis is not caused by a fungal or bacterial infection [4].
• Ointment and Emollients: Using lip balm or thick emollient ointments frequently can be sufficient treatment alone for saliva-induced angular cheilitis, as well as improving general hydration [2].

It's essential to note that the best medicine to help angular cheilitis is an antifungal cream, such as nystatin, which can clear the infection and prevent future occurrences [5]. However, if a bacterial infection is causing the condition, antibiotics may be necessary.

References:

[1] - Antifungal creams are a good solution for fungal infections in cracked, dry skin. (Source: Search Result 6) [2] - Improved general hydration can help alleviate symptoms of angular cheilitis. (Source: Search Result 2 and 5) [3] - Antibiotics may be prescribed to treat bacterial infections causing angular cheilitis. (Source: Search Result 9) [4] - Applying petroleum jelly on the inflamed areas can help alleviate symptoms if not caused by a fungal or bacterial infection. (Source: Search Result 3) [5] - Antifungal cream, such as nystatin, is effective in clearing the infection and preventing future occurrences of angular cheilitis. (Source: Search Result 8)

Angular cheilitis, also known as perlèche, can be caused by various factors, and its differential diagnosis includes several conditions that present similar symptoms.

Possible Causes

• Candidiasis: A fungal infection that can cause angular cheilitis, characterized by redness, swelling, and a cheesy discharge [4].
• Cheilitis Granulomatosa: A rare condition where the corners of the mouth become inflamed and swollen, often accompanied by pain and difficulty eating [5].
• Hyperhidrosis: Excessive sweating can lead to angular cheilitis due to the constant moisture in the skin folds [8].
• Premalignant Conditions of the Oral Cavity: Certain conditions like leukoplakia or erythroplakia can cause angular cheilitis, especially if left untreated [5].

Other Considerations

• Nutritional Deficiency: A lack of essential nutrients like vitamin B2 (riboflavin) or iron can contribute to angular cheilitis [7].
• Inflammatory Skin Disease: Conditions like eczema, psoriasis, or lichen planus can cause angular cheilitis due to inflammation and skin irritation [3][6].
• Mechanical Trauma: Friction from dentures, orthodontic appliances, or other oral devices can lead to angular cheilitis [7].

Important Note

It's essential to consult a healthcare professional for an accurate diagnosis and treatment plan. They will evaluate your symptoms, medical history, and perform a physical examination to determine the underlying cause of your angular cheilitis.

References:

[1] Lugović-Mihić et al. (2018) - Differential diagnosis includes actinic cheilitis, allergic contact cheilitis, lichen planus, etc. [4] Angular cheilitis is reported to be more common in individuals with inflammatory bowel disease (Crohn disease and ulcerative colitis), orofacial granulomatosis, or other systemic conditions. [3] [5] Differential Diagnoses - Candidiasis (angular cheilitis) · Cheilitis Granulomatosa · Hyperhidrosis · Premalignant Conditions of the Oral Cavity. [6] Angular cheilitis itself is a specific clinical finding; however, the differential for causes of angular cheilitis is quite broad, as it can be caused by various factors. [6] [7] There are several potential causes of angular cheilitis, including nutritional deficiency, inflammatory skin disease, mechanical trauma (eg, friction from dentures), etc. [7] [8] Common symptoms include erythema, dryness, scaling, fissuring, edema, itching, and burning. Cheilitis may be caused by a multiplicity of factors. [8] [9] Some skin conditions are also associated with angular cheilitis. Other causes may include: Immunodeficiency and general poor health, as in chemotherapy, etc. [9]