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Angular cheilitis

Angular cheilitis is an inflammatory condition affecting one or both corners of the mouth (labial commissures), typically presenting as erythematous, fissured, and sometimes ulcerated skin that may be painful or prone to crusting and secondary infection.^[1] It arises from a multifactorial etiology, including microbial infections, nutritional deficiencies, mechanical irritation, and underlying systemic conditions.^[1]^[2] The condition is not contagious but can become chronic if untreated, often exacerbated by factors such as drooling, ill-fitting dentures, or immunosuppression.^[1] Common symptoms include itching, burning, or tenderness at the affected sites, with potential for bleeding or weeping lesions in severe cases.^[2] Diagnosis is primarily clinical, based on history and physical examination, though swabs may identify infectious causes like Candida species or Staphylococcus aureus.^[1] Treatment targets the underlying cause: topical antifungals or antibacterials for infections, emollients or barrier creams for dryness, and correction of deficiencies (e.g., iron or vitamin B) through supplementation.^[1]^[2] In persistent cases, addressing comorbidities like diabetes or denture fit is essential to prevent recurrence.^[1] Angular cheilitis affects individuals of all ages but is more prevalent in older adults and those with edentulism or malnutrition.^[1]

Clinical presentation

Signs

Angular cheilitis manifests primarily as an inflammatory condition at the labial commissures, the corners of the mouth, where observable changes include erythema and edema leading to noticeable redness and swelling. These signs typically affect both sides of the mouth in a bilateral fashion, though unilateral involvement can occur, resulting in asymmetry. The affected areas often appear shiny and moist due to maceration, with the skin becoming soggy and lighter in color from prolonged moisture exposure.^[3]^[4] Fissuring is a key feature, presenting as linear cracks or splits in the skin that may extend radially from the commissures and can lead to superficial bleeding if aggravated. Crusting frequently develops as dried exudate forms over the fissures, creating yellowish or honey-colored scales that accentuate the inflamed appearance. In cases associated with candidal overgrowth, white plaques may appear adjacent to the commissures, resembling pseudomembranous patches that can be wiped away to reveal erythematous bases.^[5]^[4]^[3] In chronic or recurrent instances, the condition may progress to ulceration or erosion, forming shallow, painful sores at the angles of the mouth, while secondary lichenification can cause skin thickening and hyperpigmentation from repeated irritation. Blisters may also form in more severe presentations, contributing to the overall disrupted integrity of the perioral skin. These physical alterations are often more pronounced during episodes of exacerbation, highlighting the dynamic nature of the inflammatory process.^[5]^[3]

Symptoms

Patients with angular cheilitis commonly report pain, burning, or soreness at the corners of the mouth, sensations that are frequently intensified by activities such as opening the mouth wide or eating.^[6]^[3]^[7] These symptoms arise from the inflammatory process affecting the labial commissures and can vary in intensity from mild discomfort to significant irritation.^[8] In the acute phase, patients may additionally experience itching or tingling sensations in the affected areas, particularly when associated with infectious etiologies like candidiasis.^[7]^[8] Such discomfort often impairs oral intake, making eating and speaking more challenging due to heightened sensitivity.^[6]^[9] In chronic cases, the acute pain and burning may subside, giving way to persistent dryness or a sensation of tightness at the mouth corners without the same level of soreness.^[3]^[10] This ongoing dryness can contribute to further irritation if not addressed, though it is generally less disruptive to daily activities than acute episodes.^[8]

Causes

Infectious causes

Infectious causes of angular cheilitis primarily involve opportunistic microbial overgrowth in the moist, creased skin at the oral commissures, where saliva accumulation creates an ideal environment for pathogens. Fungal infections, particularly by Candida albicans, are the most common, accounting for a significant proportion of cases; this yeast colonizes the area, leading to erythematous, fissured lesions with possible white plaques. C. albicans thrives due to its ability to adhere to mucosal surfaces and produce hyphae in response to environmental moisture, often exacerbated in patients with altered oral microbiomes.^[1]^[11] Bacterial infections frequently superimpose on preexisting fungal or mechanical damage, with Staphylococcus aureus and beta-hemolytic streptococci (such as Streptococcus pyogenes) being predominant isolates; these organisms contribute to purulent inflammation and crusting. Polymicrobial involvement is typical, with combinations of Candida and staphylococci identified in 60-75% of infectious cases, as bacteria exploit breaches in the skin barrier to cause secondary infection.^[11]^[1] Viral etiologies are uncommon but can manifest in vulnerable populations, notably herpes simplex virus (HSV) type 1 in immunocompromised individuals, presenting with vesicular lesions that may ulcerate at the angles of the mouth. Such cases are rare outside of settings like HIV/AIDS or post-transplant immunosuppression, where viral reactivation occurs more readily.^[1]^[12] Key risk factors for these infections include immunosuppression from conditions like diabetes mellitus or HIV, which impairs local immune defenses and allows pathogen proliferation, as well as broad-spectrum antibiotic use that disrupts commensal oral flora and favors candidal overgrowth. The saliva accumulation that predisposes to infection is a mechanical factor detailed elsewhere. Ill-fitting dentures or habits promoting moisture retention further heighten susceptibility by fostering a persistent damp milieu.^[3]^[13]^[14]

Mechanical and irritant causes

Mechanical and irritant causes of angular cheilitis primarily involve local physical trauma and chemical exposures that disrupt the skin barrier at the labial commissures, leading to inflammation, fissuring, and erythema without primary microbial involvement. The predominant mechanism is maceration from excessive saliva exposure, which softens and breaks down the stratum corneum, creating an environment conducive to irritation.^[1] Saliva leakage often stems from behavioral habits such as frequent lip licking, which initially aims to alleviate dryness but instead perpetuates moisture accumulation and enzymatic degradation of the skin. Drooling, particularly during sleep or in individuals with anatomical variations like a downturned oral commissure, further contributes to this pooling, exacerbating tissue breakdown in the folds. Mouth breathing, commonly due to temporary nasal obstruction, similarly promotes saliva retention by altering normal lip closure and drying the mucosa, prompting compensatory licking.^[15]^[16]^[15] Mechanical friction plays a key role in aggravating these areas, often through poorly fitted oral prostheses. Ill-fitting dentures can cause repetitive rubbing and pressure at the mouth corners, leading to erythema and ulceration, especially if the appliances are overextended or unbalanced. Orthodontic appliances, such as braces or retainers that are inadequately adjusted, produce analogous frictional injury by impinging on the perioral skin. In edentulous patients, loss of vertical dimension—the reduction in jaw height following tooth loss—alters facial structure, creating deep skin folds that trap saliva and debris, thereby intensifying maceration and irritation.^[1]^[17]^[1]^[18] Irritant contact dermatitis arises from direct chemical assault on the sensitive perioral skin by everyday products. Harsh ingredients in toothpastes, such as sodium lauryl sulfate, or certain lip balms with drying agents like menthol, can provoke inflammation upon repeated application. Environmental irritants, including exposure to cold winds or low humidity, desiccate the lips and incite habitual licking, compounding the cycle of moisture-related damage. These factors collectively impair epidermal integrity, manifesting as angular cheilitis in susceptible individuals.^[17]^[3]^[3] The persistent moisture from these mechanical and irritant processes may occasionally predispose the affected areas to secondary infection, though resolution typically follows addressing the underlying local trigger.^[1]

Nutritional causes

Nutritional deficiencies represent a significant etiology for angular cheilitis, accounting for up to 25% of cases, particularly through impairments in mucosal integrity and immune function.^[1] These deficiencies often arise in vulnerable populations, including the malnourished, elderly individuals, and those with malabsorption syndromes such as celiac disease, where reduced nutrient absorption exacerbates epithelial vulnerability at the oral commissures.^[5] Iron deficiency anemia is a key nutritional factor, leading to atrophic changes in the oral mucosa that predispose to fissuring and inflammation at the mouth angles. This condition manifests as pale, smooth mucosal surfaces, with angular cheilitis appearing as erythematous cracks due to diminished tissue repair capacity.^[19] Such changes overlap with broader systemic anemias but are primarily driven by inadequate iron intake or absorption in this context.^[20] Deficiencies in B vitamins, notably riboflavin (vitamin B2), pyridoxine (vitamin B6), and cobalamin (vitamin B12), contribute to angular cheilitis by causing epithelial fragility and glossitis. Riboflavin deficiency disrupts cellular metabolism, resulting in maceration and pallor of the perioral mucosa, often presenting as cheilosis with angular fissures.^[21] Pyridoxine deficiency similarly impairs epithelial cell turnover, leading to stomatitis and commissural erosions, while cobalamin deficiency induces megaloblastic changes that weaken mucosal barriers, facilitating cheilitis alongside atrophic glossitis.^[1]^[22] Zinc deficiency further promotes angular cheilitis through compromised wound healing and reduced immune surveillance, resulting in persistent perioral dermatitis and acrodermatitis-like lesions. This micronutrient shortfall affects keratinocyte proliferation and collagen synthesis, heightening susceptibility to secondary irritation at the labial folds.^[23] It is particularly prevalent in settings of chronic malnutrition or gastrointestinal disorders impairing zinc uptake.^[24]

Systemic and other causes

Systemic disorders can predispose individuals to angular cheilitis through mechanisms such as impaired immune function, altered salivary composition, or mucosal dryness. Diabetes mellitus, particularly type 2, is associated with a higher prevalence of angular cheilitis due to hyperglycemia promoting Candida overgrowth in saliva and delayed wound healing.^[1]^[25] In patients with HIV/AIDS, angular cheilitis manifests frequently as an oral opportunistic infection, often linked to candidiasis or bacterial involvement, exacerbated by immunosuppression.^[26]^[27] Sjögren's syndrome contributes via severe xerostomia, leading to lip cracking and secondary infections like angular cheilitis, which is one of the most common oral mucosal lesions in affected individuals.^[28]^[29] Allergic contact dermatitis represents another systemic immunological factor in angular cheilitis, where exposure to allergens triggers localized inflammation at the oral commissures. Common culprits include nickel from jewelry or lip-contacting metals, as well as flavorings and preservatives in oral hygiene products like toothpastes or lip balms.^[30]^[17] These reactions often present with erythema, fissuring, and pruritus, distinguishing them from infectious etiologies through patch testing confirmation.^[16] Certain medications induce angular cheilitis by causing mucocutaneous dryness or direct irritation. Systemic retinoids, such as isotretinoin used for acne, frequently lead to cheilitis through disruption of skin barrier function and reduced sebum production, affecting up to 90% of users.^[31]^[17] Chemotherapy agents, particularly those in combination regimens, promote angular cheilitis via mucosal toxicity, xerostomia, and increased susceptibility to opportunistic infections.^[32]^[33] Other conditions contribute through anatomical or functional predispositions. In Down syndrome, macroglossia, hypotonia, and open-mouth posture increase saliva pooling at the commissures, elevating angular cheilitis incidence to approximately 25-38% in affected individuals.^[1]^[34] Parkinson's disease similarly heightens risk due to sialorrhea (excessive drooling) from dysphagia and reduced oral control, fostering moisture retention and secondary infections.^[35]^[36] Nutritional deficiencies underlying systemic anemias may overlap here, though isolated dietary factors are addressed separately.^[37]

Diagnosis

Clinical evaluation

The clinical evaluation of angular cheilitis begins with a thorough history taking to assess the onset, duration, and pattern of recurrence of the lesions, as well as associated symptoms such as pain, burning, itching, or difficulty eating.^[5] Patients should be queried about risk factors, including the use of dentures or orthodontic appliances that may cause mechanical irritation, inhalation of corticosteroids for asthma, poor oral hygiene, dietary habits suggestive of nutritional deficiencies (e.g., low intake of iron, vitamin B, or zinc), and systemic conditions like diabetes mellitus or immunosuppression.^[38] Inquiring about recent infections, allergies to lip products, or exposure to irritants helps identify potential triggers.^[39] Physical examination focuses on inspection of the oral commissures, typically revealing bilateral erythema, fissuring, scaling, crusting, or maceration at the angles of the mouth, often with moisture accumulation from saliva.^[1] The exam should evaluate for unilateral versus bilateral involvement, signs of secondary bacterial or fungal infection such as exudate, pustules, or odor, and extension to adjacent skin or mucosa.^[39] Associated findings, like intraoral thrush or lip dryness, are noted, along with assessment of dentition, occlusion, and overall nutritional status through observation of weight and skin integrity.^[38] Palpation may detect tenderness or induration, guiding suspicion of deeper involvement. Differential diagnosis requires distinguishing angular cheilitis from similar perioral conditions, such as herpes labialis (vesicular, unilateral, with prodrome), actinic cheilitis (chronic scaling on sun-exposed vermilion border), impetigo (contagious bacterial with honey-colored crusts), and allergic contact dermatitis (pruritic, related to specific exposures).^[16] Other considerations include perioral dermatitis or nutritional glossitis, based on history and exam patterns.^[38] Underlying causes should be suspected in cases with red flags, including rapid weight loss, chronic immunosuppression (e.g., HIV or chemotherapy), persistent or recurrent lesions unresponsive to initial care, or systemic symptoms like fatigue and glossodynia, prompting further workup for deficiencies or malignancies.^[38] If infection is clinically suspected, a single swab for microbial culture from the lesion may aid in identifying pathogens like Candida or Staphylococcus.^[5]

Classification

Angular cheilitis is primarily classified based on its etiology, including infectious, irritant, allergic, nutritional, and multifactorial categories.^[1] Severity is graded as acute or chronic, with acute presentations featuring sudden-onset erythema, fissuring, and crusting that may evolve rapidly to ulceration if untreated. Chronic forms persist or recur, characterized by hyperkeratosis, granulation tissue, and potential scarring due to prolonged inflammation. Alternative classifications distinguish reversible (transient) cases responsive to local interventions from irreversible (persistent) ones linked to ongoing systemic issues or anatomical defects.^[1]^[16]^[40] The condition is further categorized as primary or secondary, where primary angular cheilitis arises idiopathically from local factors without systemic involvement, often resolving with targeted local therapy. Secondary forms manifest as a symptom of broader systemic diseases, such as diabetes, HIV, or autoimmune disorders, requiring identification and management of the underlying pathology.^[1]^[16] A clinical staging system proposed by Ohman et al. (1986) classifies angular cheilitis based on the extent of rhagades (fissures) and erythema:

Management

General measures

General measures for angular cheilitis focus on supportive interventions that protect the affected skin, reduce irritation, and promote healing without targeting specific etiologies. These approaches are often the first line of care and can be sufficient for mild cases caused by moisture or friction.^[5] Barrier protection plays a key role in preventing further irritation from saliva or environmental factors. Applying petroleum jelly, zinc oxide paste, or lip balm frequently to the corners of the mouth creates a protective layer that shields the skin from moisture and aids in maintaining barrier integrity.^[3]^[41]^[42] Hygiene practices are essential to minimize aggravation and support recovery. Gentle cleansing of the area with water and mild soap, followed by thorough patting dry, helps remove saliva and debris while preventing maceration; patients should also avoid lip licking to reduce saliva accumulation and keep the region dry.^[5]^[3] For individuals wearing dentures, adjustments to ensure proper fit are crucial to eliminate mechanical factors like folding or friction that contribute to skin breakdown. Consultation with a dentist for refitting or realignment can alleviate pressure on the commissures and prevent recurrence.^[3]^[5] Patient education emphasizes lifestyle modifications to avoid exacerbating factors. Individuals are advised to steer clear of irritants such as spicy foods, acidic substances, or harsh toothpastes, which can worsen inflammation and delay healing.^[5]^[3] These supportive strategies provide symptomatic relief, but complete resolution typically requires addressing any underlying causes through targeted therapies.^[1]

Targeted therapies

Targeted therapies for angular cheilitis address the underlying etiology, such as infections, nutritional deficiencies, inflammation, or systemic conditions, to promote resolution and prevent recurrence.^[1] For cases involving candidal infections, which are common due to moisture accumulation and microbial overgrowth at the oral commissures, topical antifungals are the first-line intervention. Agents such as nystatin ointment or clotrimazole cream are applied two to four times daily for 7 to 14 days, effectively reducing fungal load and alleviating erythema and fissuring. Combination products containing antifungals and low-potency corticosteroids (e.g., miconazole with 1% hydrocortisone) are often used for cases with significant inflammation.^[1]^[43] In severe or refractory cases, oral fluconazole at 100 to 200 mg daily for 7 to 14 days may be considered, particularly when topical therapy is insufficient.^[1] Bacterial superinfections, often involving Staphylococcus aureus or Streptococcus species, require targeted antibiotic therapy to eradicate pathogens and resolve crusting and ulceration. Topical mupirocin ointment applied three times daily for 5 to 7 days is recommended for staphylococcal involvement, showing high efficacy in clearing infection without systemic absorption.^[1]^[18] Fusidic acid may serve as an alternative for bacterial infections, particularly staphylococcal cases, with combination use alongside antifungals if mixed infection is suspected.^[18] Nutritional deficiencies contribute to up to 25% of angular cheilitis cases, particularly involving iron, vitamin B complex (such as B2, B6, B12, and folate), or zinc, which impair mucosal integrity and immune function. Supplementation with oral iron (e.g., ferrous sulfate 325 mg daily), B vitamins (e.g., riboflavin 10 mg daily or a B-complex formulation), or zinc (e.g., zinc sulfate 220 mg daily) is indicated following laboratory confirmation of deficiency, with symptoms often improving within weeks.^[1]^[44] Ongoing monitoring of serum levels is essential to adjust dosing and avoid overload, especially in patients with malabsorption or chronic conditions.^[23] Inflammatory or allergic components, such as those from irritant or allergic contact dermatitis, benefit from low-potency topical corticosteroids to reduce edema and pruritus. Hydrocortisone 1% ointment applied twice daily for up to 7 days provides symptomatic relief without significant atrophy risk, but long-term use is avoided to prevent skin thinning and secondary infection.^[1]^[6] Systemic management targets predisposing conditions like diabetes mellitus or contact allergies. In diabetic patients, optimizing glycemic control through diet, exercise, and medications reduces susceptibility to infections and supports healing, as poor control correlates with higher prevalence of angular cheilitis.^[45] For allergic contact dermatitis, strict allergen avoidance—such as discontinuing lip products containing common sensitizers like nickel or fragrances—is crucial, often leading to rapid improvement when combined with topical therapy.^[1] Supportive barriers, like petrolatum, may enhance these targeted approaches by protecting the area from saliva.^[1]

Outcomes

Prognosis

Angular cheilitis generally has a favorable prognosis with prompt and appropriate treatment, as it is a highly manageable condition that poses no inherent risk to life. Acute cases typically show improvement within the first few days and resolve completely within 1 to 2 weeks. In many instances, the condition is curable, with full healing observed in 1 to 4 weeks when antifungal or combined therapies are applied effectively. Up to 80% of cases may recur within 5 years if underlying risk factors are not addressed.^[1] However, if the underlying cause remains unaddressed, angular cheilitis can become chronic or recurrent, leading to persistent inflammation and discomfort. Longstanding cases may result in tissue atrophy, and although rare, permanent scarring or discoloration can occur. Effective management of predisposing factors, such as microbial infections or mechanical irritants, significantly improves outcomes and reduces the likelihood of recurrence. Potential complications include secondary bacterial or fungal infections, which can exacerbate symptoms and prolong recovery if not treated. In severe or untreated cases, the inflammation may extend to perioral dermatitis or lead to chronic skin changes. Factors that worsen the prognosis include immunosuppression, which impairs healing and increases susceptibility to infections; poor nutritional status, contributing to delayed resolution; and patient non-compliance with treatment regimens. Addressing these through targeted interventions, as outlined in management strategies, can mitigate risks and promote better long-term outcomes.

Prevention

Maintaining good oral hygiene practices, such as regular brushing, flossing, and rinsing the mouth, helps prevent microbial overgrowth that can contribute to angular cheilitis.^[5] Ensuring adequate nutritional intake is key to preventing deficiencies linked to the condition; a balanced diet rich in iron, B vitamins (particularly riboflavin), zinc, and protein supports mucosal integrity and immune function, while staying well-hydrated by drinking sufficient water reduces dryness.^[3]^[5]^[2] For denture wearers, who are at higher risk due to potential moisture trapping, proper denture care involves daily cleaning with appropriate solutions and ensuring a good fit through routine dental check-ups to avoid skin folds and irritation.^[5]^[3]^[2] Lip protection strategies include frequent application of emollients like lip balm or petroleum jelly, especially in dry, cold, or windy environments, to preserve the skin barrier and prevent cracking; avoiding lip-licking habits further reduces saliva-induced maceration. Quitting smoking is recommended to reduce irritation and improve healing.^[5]^[3]^[2] Steering clear of known allergens and irritants, such as expired cosmetics or certain lip products, minimizes inflammatory responses at the oral commissures.^[5]^[2] In individuals experiencing recurrent episodes, screening for systemic conditions—such as diabetes, immunosuppression, or ongoing nutritional deficits through blood tests and clinical evaluation—is advised to identify and manage underlying contributors.^[5]^[3]

Background

Epidemiology

Angular cheilitis is a relatively common condition, with a reported prevalence of 0.7% in the general American population.^[1] It occurs more frequently among older adults, particularly those in institutionalized settings or with denture use, where prevalence can reach up to 28% among elderly denture wearers compared to non-denture users.^[46] Studies indicate variability, with some reporting rates as high as 34% in geriatric hospital populations with dentures and overall elderly prevalence ranging from 1% to 46.66% across different cohorts.^[47]^[48] The condition shows increased prevalence in specific at-risk groups, including denture wearers, where the odds of occurrence are threefold higher than in non-wearers.^[49] Malnutrition, particularly deficiencies in iron, vitamin B complex, folate, or zinc, is associated with higher rates, though exact prevalence figures in these populations vary and are often linked to underlying systemic issues.^[1] Similarly, immunocompromised individuals, such as those with HIV/AIDS, experience elevated incidence, ranging from 5.6% to 28.9%.^[14] There is no strong gender bias in the occurrence of angular cheilitis, though some studies report a slight predominance in females, with ratios around 60% female to 40% male in clinical samples.^[50] This may relate to behavioral factors, but evidence is inconsistent across populations.^[51] Geographic variations are minimal, with no pronounced regional differences reported; however, higher rates may occur in areas with widespread nutritional deficiencies due to socioeconomic or dietary factors.^[52]

Etymology

The term "angular cheilitis" derives from the Greek word cheilos, meaning "lip," combined with the suffix -itis, denoting inflammation, specifically referring to the inflammatory condition at the angles or corners of the mouth.^[1] This nomenclature emphasizes the localized involvement of the labial commissures, distinguishing it from more generalized lip inflammations.^[53] Synonyms for angular cheilitis include "perlèche" (or "perleche"), "angular stomatitis," and "cheilosis." The term "perlèche" originates from the French phrase pour lèche, meaning "to lick excessively" or "lick the edges," reflecting the historical observation of patients licking the irritated corners of their mouths due to discomfort.^[1] "Angular stomatitis" highlights the inflammatory changes extending to the adjacent oral mucosa, while "cheilosis" broadly encompasses lip-related inflammatory disorders.^[54] Historically, "perlèche" was first described in 1855 by French physician J. Lemaistre as an infectious condition primarily affecting the mouth's corners, often linked to microbial causes like streptococci. Over the 20th century, as clinical understanding advanced, the terminology evolved to "angular cheilitis" to better capture its multifactorial etiology, incorporating not only infectious agents but also nutritional deficiencies, mechanical irritants, and systemic factors, rather than attributing it solely to infection.^[41] This shift in naming parallels broader dermatological progress in recognizing complex, overlapping causes in oral inflammatory conditions.^[1]

References

[1]
Angular Chelitis - StatPearls - NCBI Bookshelf - NIH
Mar 7, 2023 · Angular cheilitis describes an inflammatory skin process of variable etiology occurring at the labial commissure, the angle of the mouth.Etiology · History and Physical · Evaluation · Treatment / Management
[2]
Angular Cheilitis: What to Know - WebMD
Feb 14, 2025 · Angular cheilitis is a condition that causes red, swollen patches in the corners of your mouth where your lips meet and make an angle.Missing: definition | Show results with:definition
[3]
Angular Cheilitis: What it is, Symptoms, Causes & Treatments
Angular cheilitis causes cracked, irritated skin at the corners of your mouth. Treatments include ointment, medication and diet changes.
[4]
Angular cheilitis - Primary Care Dermatology Society
Nov 21, 2021 · Clinical findings. One, or more commonly both, angles of the mouth are affected; Signs may include erythema, fissures, ooze, and crusting ...Missing: physical | Show results with:physical
[5]
Angular Cheilitis: Symptoms, Causes, and Management with Images
Angular cheilitis is a common, non-contagious, inflammatory condition affecting the corners of the mouth or oral commissures.Missing: NCBI | Show results with:NCBI
[6]
A Triad of Dermatologic Dilemmas - PMC - NIH
Angular Chelitis (AC) is an inflammation of the vermilion commissures and adjacent mucous membranes which can rapidly escalate to erythema, moist maceration, ...Missing: definition | Show results with:definition
[7]
Angular cheilitis: Treatment, causes, and contagiousness
Angular cheilitis causes pain and inflammation in the corners of the mouth. It can become infected, which can spread if left untreated. Learn more here.What is angular cheilitis? · Causes · Risk factors
[8]
Angular Cheilitis: Symptoms, Causes, Treatment, and Prevention
Dec 18, 2024 · Symptoms of angular cheilitis · bleeding · red · swollen · cracked · blistered · crusty · itchy · painful.Symptoms · Pictures · Diagnosis · TreatmentMissing: physical presentation
[9]
Cracks at the corners of your mouth: angular cheilitis - Aspen Dental
Oct 10, 2025 · Symptoms of angular cheilitis and when to get help · Tightness or soreness when opening your mouth wide · Dry, peeling skin at one or both corners.
[10]
Angular Cheilitis: Cracked Skin Around the Mouth - Verywell Health
Oct 9, 2025 · Mild angular cheilitis causes discomfort and tightness at the oral commissures. It may also cause flaky skin and discoloration, along with ...Missing: dryness | Show results with:dryness
[11]
Cheilitis: A Diagnostic Algorithm and Review of Underlying Etiologies
Polymicrobial infections cause most cases of angular cheilitis, and a combination of Candida albicans and S. aureus comprises 60%–75% of cases. Open in ViewerAllergic Contact Cheilitis · Actinic Cheilitis · Infectious Etiologies
[12]
Angular cheilitis - Symptoms, diagnosis and treatment
Nov 17, 2022 · Etiology is multifactorial and includes mechanical factors, infectious agents, nutritional deficiencies, or inflammatory dermatologic conditions ...
[13]
Angular Cheilitis: What Is It, Causes, Treatment, and More - Osmosis
Sep 30, 2025 · Angular cheilitis can cause bleeding, blistering, or crusting, especially if a bacterial infection is present. The affected area may become red ...Missing: subjective | Show results with:subjective
[14]
Angular Cheilitis - An Updated Overview of the Etiology, Diagnosis ...
Aug 7, 2025 · 4 Angular cheilitis in this patient was caused by C. albicans infection and was exacerbated by the xerostomia condition due to high blood ...
[15]
Art of prevention: Practical interventions in lip-licking dermatitis - NIH
For example, patients with allergic rhinitis can develop angular cheilitis as a result of nasal congestion that leads to mouth breathing and pooling of saliva ...
[16]
DIFFERENTIAL DIAGNOSIS OF CHEILITIS – HOW TO CLASSIFY ...
Angular cheilitis occurs more commonly in diabetics, in patients with some psychiatric disorders (e.g., lip trauma in bulimics or in anorexia nervosa), during ...
[17]
Cheilitis - StatPearls - NCBI Bookshelf - NIH
Aug 17, 2023 · Cheilitis is an inflammation of the lips. It may be acute or chronic, involving the vermilion and/or surrounding skin of one or both lips.
[18]
Answer: Can you identify this condition? - PMC - NIH
Angular cheilitis is an inflammatory condition that occurs in 1 or both angles of the mouth. This condition typically presents with erythema, painful cracking, ...
[19]
Angular cheilitis induced by iron deficiency anemia
Aug 1, 2018 · Nutritional deficiencies account for 25% of all cases of angular cheilitis and include iron deficiency and deficiencies of the B vitamins ...Missing: atrophic mucosa
[20]
Oral pathology in inflammatory bowel disease - PubMed Central - NIH
Angular cheilitis and glossitis are frequently caused by anemia and malnutrition; in cases with specific deficiencies, the replacement of iron, B12, folate and ...
[21]
Skin findings associated with nutritional deficiencies
Oct 1, 2016 · Features of vitamin B2 deficiency include angular stomatitis, glossitis, cheilosis, nasolabial dermatitis, and rarely corneal vascularization.
[22]
Cutaneous signs of nutritional disorders - PMC - NIH
Sep 22, 2021 · Angular cheilitis and aphthous stomatitis have also been associated with vitamin B12 deficiency (Brescoll and Daveluy, 2015; Vigarios et al., ...
[23]
Zinc Deficiency - StatPearls - NCBI Bookshelf
Aug 2, 2025 · Skin manifestations: Chronic zinc deficiency can cause or exacerbate dermatologic conditions such as acrodermatitis enteropathica, cheilitis, ...<|control11|><|separator|>
[24]
Combined zinc and vitamin B6 deficiency in a patient with diffuse ...
Aug 2, 2019 · This deficiency is associated with angular cheilitis, glossitis, cognitive symptoms and reduced immunity. There is also an established ...
[25]
Prevalence of Oral Mucosal Lesions in Patients with Type 2 ... - NIH
Patients with diabetes had a higher prevalence of geographic tongue (GT) (P = 0.017), denture stomatitis (P = 0.018), and angular cheilitis (P = 0.006) than ...
[26]
Oral manifestations of HIV - PMC - NIH
Angular cheilitis is erythema and/or fissuring and cracks of the corners of the mouth. Angular cheilitis can occur with or without the presence of ...
[27]
Case Series of HIV-Associated Oral Lesions Among Antiretroviral ...
Jan 30, 2023 · ... angular cheilitis, necrotizing ulcerative gingivitis, linear gingival erythema, cytomegalovirus-associated ulcers, and oral hairy leukoplakia.
[28]
Oral mucosal manifestations in primary and secondary Sjögren ...
Feb 29, 2016 · The second most frequent sign was angular cheilitis, cheilitis, including exfoliative cheilitis. The lips were fissured, exfoliative, bleeding ...
[29]
Oral lesions in Sjögren's syndrome: A systematic review - PMC - NIH
Angular cheilitis, oral manifestations of candidiasis, ulcerations, atrophic glossitis and grooves or fissuration of the tongue were the most reported lesions.
[30]
ASSOCIATION BETWEEN ALLERGIC REACTIONS AND LIP ... - NIH
... angular cheilitis (1). Dental materials that can cause an allergic reaction include mercury, cobalt, chromium, impression materials, eugenol, etc. (1, 13) ...<|control11|><|separator|>
[31]
Objective Assessment of Isotretinoin-Associated Cheilitis - NIH
... angular cheilitis. Further studies are needed to assess if the ICGS can be adapted to other forms of cheilitis. The ICGS is straightforward in addition to ...
[32]
Mucosal Injury during Anti-Cancer Treatment: From Pathobiology to ...
Lip erythema, erosions, cracks and angular cheilitis are quite common. Deeper mucosal lesions are not very frequent; they only occur during combination ...
[33]
A systematic review of oral fungal infections in patients receiving ...
Angular cheilitis: presents as erythema, fissuring, and crusting of the commissures (angles) of the lips. The most common forms of intraoral candidiasis ...
[34]
Lip and oral lesions in children with Down syndrome. A controlled ...
The high incidence of angular cheilitis in DS subjects seen in this study may be caused by Candida albicans as a result of drooling and immune defects in these ...Missing: irritant | Show results with:irritant
[35]
Oral Health Disorders in Parkinson's Disease - PubMed Central - NIH
Jul 8, 2021 · •Angular cheilitis, •Periodontal diseases (periodontitis), dental caries, denture problems, missing teeth, bruxism, NA, •No difference in oral ...
[36]
Radiation of parotid or submandibular glands is effective for drooling ...
Feb 14, 2022 · Drooling is associated with an increased risk of candidiasis, stomatitis and angular cheilitis [8]. Excessive drooling in parkinsonian patients ...
[37]
Iron Deficiency Anemia Begets Angular Cheilitis and Atrial ... - NIH
Angular cheilitis is a specific type of cheilitis characterized by inflammatory affecting the vermilion and surrounding skin of the lips.Missing: definition | Show results with:definition
[38]
Common Oral Lesions: Part I. Superficial Mucosal Lesions - AAFP
Feb 15, 2007 · Recognition and diagnosis require taking a thorough history and performing a complete oral examination ... (angular cheilitis). Oral ...
[39]
Angular cheilitis - Symptoms, Causes, Images, and Treatment Options
... Angular cheilitis, including symptoms, causes, differential diagnosis, and treatment options. ... Diagnosis is usually made via history and physical examination ...
[40]
[PDF] Angular Cheilitis, Part 1: Local Etiologies
4-10 Angular cheilitis can evolve into diffuse cheilitis involving the entire surface of the upper and lower lips. ... Angular Cheilitis, Part 1: Local Etiologies.
[41]
Angular Cheilitis - an overview | ScienceDirect Topics
Angular cheilitis (perlèche) is defined by fissures, erythema, and encrustations at the corners of the mouth, and is commonly seen in patients with dental ...Mucocutaneous Candidiasis · Superficial Infections · DermatophytosisMissing: etiology | Show results with:etiology
[42]
Chapter 34: Angular Cheilitis - AccessMedicine
Lip licking can cause a contact dermatitis to the saliva along with perlèche (Figure 34-4). Perlèche is derived from the French word lecher, meaning "to lick.".Missing: classification | Show results with:classification<|control11|><|separator|>
[43]
Angular Cheilitis (Perleche, Angular Stomatitis, Cheilosis)
Mar 13, 2019 · Affected patients may complain of a burning sensation or tenderness at the corners of the mouth. The discomfort associated with this eruption ...<|control11|><|separator|>
[44]
Angular Cheilitis: Symptoms, Risks & Treatment | Colgate®
Angular Cheilitis describes the inflammation and dry, cracked skin at one or both corners of the mouth.
[45]
Treatment of angular cheilitis: A narrative review and authors ...
Angular cheilitis (AC) is a clinical entity first described in the XIX century, characterized by erythema, rhagades, ulcerations, and crusting of one or both ...
[46]
Oral manifestations of iron imbalance - PMC - PubMed Central - NIH
Sep 11, 2023 · Iron deficiency anemia is the most common manifestation of low serum levels of iron, and it can manifest in the oral cavity by angular cheilitis ...
[47]
Oral Manifestations and Complications of Diabetes Mellitus: A review
Angular chelitis is seen in the lip commissures as an erythematous crusting lesion. The lesion has been reported to occur in diabetics with poor glycaemic ...
[48]
https://talenta.usu.ac.id/dentika/article/view/9507
[49]
Risk factors for denture-related oral mucosal lesions in a geriatric ...
Angular cheilitis (34%), traumatic ulcers (15%), and denture stomatitis (14%) were the 3 most common lesions, and the prevalence of at least 1 denture ...
[50]
Prevalence of Angular Cheilitis in the Elderly: A Rapid Review
Jun 26, 2023 · The lowest and highest prevalence value was 1% and 46.66%, respectively, with 1,347 out of 14,927 elderly experiencing angular cheilitis. Of the ...
[51]
Age, gender, dentures and oral mucosal disorders - PubMed
Neither age alone nor the quality of dentures predispose to mucosal lesions, but that the odds of finding stomatitis, denture-related hyperplasia and angular ...Missing: elderly wearers geographic variations
[52]
Angular Cheilitis: A Clinical and Microbial Study
Angular cheilitis was seen slightly more frequently in women than men in our study; female patients were 24 (60.0%) and male patients 16 (40.0%) [Table 1].
[53]
Angular cheilitis | First Derm
The occurrence of angular cheilitis shows no gender preference according to studies. Good oral hygiene, though, has been found to significantly reduce its ...Missing: prevalence | Show results with:prevalence
[54]
Angular cheilitis (angular stomatitis) - Pocket Dentistry
Feb 18, 2015 · GEOGRAPHIC. No known geographic incidence. PREDISPOSING FACTORS. Angular cheilitis is most often chronic, seen in the older, and due to ...
[55]
Angular Chelitis - PubMed
Mar 7, 2023 · Angular cheilitis (AC) is a descriptive diagnosis for an inflammatory skin process of varied etiology occurring at the labial commissure – the angle of the ...Missing: symptoms | Show results with:symptoms