Angular cheilitis

Overview


Angular cheilitis (also called perlèche, 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 vitamin B (Riboflavin B2 and Cyanocobalamin B12 ) and iron deficiency anemia, which in turn may be evidence of poor diets or malnutrition (e.g. celiac disease).

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. The child may lick their lips in an attempt to provide a temporary moment of relief, only serving to worsen the condition.

Treatment
In mild cases in teenagers and young children (only having chapped lips), encouraging them not to lick their lips and applying protective paraffin-based ointment (such as Vaseline) or lip balms to the lips is normally very effective.

For more severe angular cheilitis, depending on the cause, antifungal and antibiotic medication (e.g. topical miconazole oral gel that has dual activity), vitamins supplements, and dentures for a person without teeth can abate the symptoms.