Angular cheilitis

Angular cheilitis
Classification and external resources
Affected within the black circle
ICD-10	K13.0
ICD-9	528.5

Angular cheilitis (also called perlèche^[1]:309, cheilosis or angular stomatitis) is an inflammatory lesion at the labial commissure, or corner of the mouth, and often occurs bilaterally. The condition manifests as deep cracks or splits. In severe cases, the splits can bleed when the mouth is opened and shallow ulcers or a crust may form.

Causes

Although the disease has an unknown etiology, the sores of angular cheilitis may become infected by the fungus Candida albicans (thrush), or other pathogens. Studies have linked the initial onset with nutritional deficiencies, namely riboflavin (vitamin B₂)^[2][3] and iron deficiency anemia,^[3] which in turn may be evidence of poor diets or malnutrition (e.g. celiac disease). Zinc deficiency has also been associated with angular cheilitis.^{[citation needed]}

Cheilosis may also be part of a group of symptoms (upper esophageal web, iron deficiency anemia, glossitis, and cheilosis) defining the condition called Plummer-Vinson syndrome (aka Paterson-Brown-Kelly syndrome).

Angular cheilitis occurs frequently in the elderly population who experience a loss of vertical dimension due to loss of teeth, thus allowing for over-closure of the mouth.

Less severe cases occur when it is quite cold (such as in the winter time), and is widely known as having chapped lips. This lesser form mostly happens to young children/teenagers.^{[citation needed]} The child may lick their lips in an attempt to provide a temporary moment of relief, only serving to worsen the condition.^[4]

Angular cheilitis can be caused by bacteria, but is more commonly a fungal infection. It can also be caused by medications which dry the skin, including isotretinoin (Accutane), an analog of vitamin A. Less commonly, it is associated with primary hypervitaminosis A ^[5]

Treatment

Treatment depends on the cause. For minor cases, disinfecting the area with a "Q-tip amount" of rubbing alcohol to kill any bacteria, then apply Neosporin generously to the corner of mouth throughout the day. The Neosprin continues to kill the bacteria and heal the cuts that had formed without scarring. Always keep the area clean before applying. The infection should subside within a day or two. In more serious cases, see a doctor.

Certain cases are caused by malabsorbtion syndrome. This is ameliorated by B-12 shots, or especially by the entire B complex shots. The amount given and the frequency of shots is determined by the severity of the leisons and the history of the response once healing is achieved.

See also

• Candidiasis
• List of cutaneous conditions

Footnotes

4. http://www.scribd.com/doc/5567409/Angular-Cheilitis

1. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
2. ^ MedlinePlus (2005-08-01). "Riboflavin (vitamin B2) deficiency (ariboflavinosis)". National Institutes of Health. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-riboflavin.html. 
3. ^ ^{a b} Lu S, Wu H (2004). "Initial diagnosis of anemia from sore mouth and improved classification of anemias by MCV and RDW in 30 patients". Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98 (6): 679–85. doi:10.1016/j.tripleo.2004.01.006. PMID 15583540. 
4. ^ Mayo Clinic http://www.mayoclinic.com/health/chapped-lips/AN01440
5. ^ Kliegman: Nelson Textbook of Pediatrics, 18th ed.

Fitzpatrick's color atlas of clinical dermatology