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Angular cheilitis is a common inflammatory condition affecting the corners of the mouth or oral commissures. Depending on underlying causes, it may last a few days or persist indefinitely. It is also called angular stomatitis, cheilosis and perleche (perlèche).

Causes

This condition is due to one or more of the following factors:

  • A dribble of saliva causing eczematous cheilitis, a form of contact irritant dermatitis
  • Facial wrinkles that occur with natural aging (marionette lines)

  • Dry chapped lips
  • Proliferation of bacteria (impetigo), yeasts (thrush) or virus (cold sores).
Who is prone to angular cheilitis?

Angular cheilitis is common and affects children and adults, especially when they are in poor health. Predisposing factors include:

  • Oral thrush: infancy, old age, diabetes, systemic corticosteroid or antibiotic use
  • Dentures, especially if they are poor fitting, and there is associated gum recession
  • Poor nutrition: coeliac disease, iron deficiency, riboflavin deficiency
  • Systemic illness, particularly inflammatory bowel disease (ulcerative colitis and Crohn disease)
  • Sensitive skin, especially atopic dermatitis
  • Genetic predisposition, for example in Down syndrome
  • Oral retinoid medication: isotretinoin for acne, acitretin for psoriasis.

It is made worse by licking the lips.

Clinical features

Angular cheilitis may result in the following symptoms and signs at the corners of the mouth:

  • Painful cracks/fissures
  • Blisters, erosions, oozing, crusting
  • Redness
  • Bleeding.

It may progress to more widespread impetigo or candidiasis on the adjacent skin and elsewhere.

 

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