Angular Cheilitis

Angular cheilitis, also known as perleche, is a condition characterized by inflammation and painful cracks at the corners of the mouth. This condition can be caused by various factors and can affect individuals of all ages.

Causes of Angular Cheilitis:

  1. Infections:
    • Fungal: The most common cause is a fungal infection, often due to Candida albicans.
    • Bacterial: Bacterial infections, particularly from Staphylococcus aureus, can also be a cause.
  2. Nutritional Deficiencies:
    • Deficiencies in iron, riboflavin (vitamin B2), folate, or vitamin B12 can contribute to the development of angular cheilitis.
  3. Skin Conditions:
    • Conditions like eczema or atopic dermatitis can predispose individuals to angular cheilitis.
  4. Mechanical Factors:
    • Excessive saliva accumulation in the corners of the mouth, often due to habits like lip licking or drooling, can create a moist environment conducive to infections.
    • Poorly fitting dentures can also cause drooling and irritation in the corners of the mouth.
  5. Systemic Conditions:
    • Diabetes mellitus and immunosuppression (e.g., due to HIV/AIDS) can increase susceptibility to infections leading to angular cheilitis.

Symptoms:

  • Redness, swelling, and cracking at the corners of the mouth.
  • Pain or discomfort, especially when opening the mouth or eating.
  • Sometimes, bleeding or crusting can occur.

Treatment:

  1. Topical Treatments:
    • Antifungal creams: For cases caused by fungal infections (e.g., clotrimazole or miconazole).
    • Antibacterial ointments: For bacterial infections (e.g., mupirocin or fusidic acid).
    • Barrier creams: To protect the skin from saliva and other irritants.
  2. Addressing Underlying Causes:
    • Nutritional supplements: If a deficiency is identified, appropriate supplementation (e.g., iron, B vitamins) should be provided.
    • Proper fitting of dentures: Ensuring that dentures fit well to prevent drooling and irritation.
    • Good oral hygiene: Maintaining good oral hygiene to prevent infections.
  3. General Care:
    • Keeping the affected area dry and protected.
    • Avoiding habits that exacerbate the condition, such as lip licking or biting.

Prevention:

  • Maintaining good oral hygiene.
  • Regular dental check-ups to ensure proper fitting of dentures.
  • Adequate nutrition to prevent deficiencies.
  • Managing chronic conditions like diabetes effectively.