- Definition: Non-contagious, inflammatory condition affecting the corners of the mouth (oral commissures)
- Affected Population: Can affect any child or adult; more common in those with poor health
- Resolution: Typically self-resolves
Risk Factors
- Dry Chapped Lips: From any cause
- Oral Thrush: More likely in:
- Infants
- Elderly
- Diabetics
- Corticosteroid or antibiotic users
- Immunocompromised patients
- Dentures: Especially if ill-fitted with associated gum recession
- Poor Nutrition:
- Coeliac disease
- Iron deficiency
- Riboflavin deficiency
- General protein deficiency
- Zinc deficiency
- Vitamin B12 and/or folate deficiency
- Systemic Illnesses:
- Inflammatory bowel disease (ulcerative colitis and Crohn’s disease)
- Sjogren syndrome
- Sensitive Skin: Particularly atopic dermatitis
- Genetic Predisposition: e.g., Down syndrome
- Oral Retinoid Medication: Can cause dry lips, e.g., isotretinoin, acitretin
- Rapid Weight Loss: Leads to reduced skin turgor/elasticity and increased skin folds
- Smoking: Reduces skin turgor/elasticity
- Retrognathia: Abnormal posterior/set-back position of the jaw
- Upper Lip Overhang: Resulting in deep furrows (marionette lines)
- Lip Licking: Worsens the condition
Diagnosis
- Swab Cultures: May reveal:
- Candida albicans
- Staphylococcus aureus
- Herpes simplex (cold sores)
Treatment
General Measures
- Hydration: Improve general hydration
- Lip Balm/Emollient Ointment: Apply frequently; often sufficient for saliva-induced angular cheilitis
- Topical Antiseptics
Specific Measures
- Topical Antifungal Cream
- Oral Antifungal Medication
- Topical or Oral Antistaphylococcal Antibiotic
- Topical Steroid Ointment: If the skin is significantly inflamed
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