Cheilitis

Extract

• Often associated with edentulousness, dentures and overclosing of the mouth leading to an increased skin fold at the angle of the mouth (picture 1). Constantly pooling saliva at the skin fold creates an ideal environment for fungal and bacterial infections. Angular cheilitis can also be associated with an oral yeast infection.
• In 20% of cases the causative agent is Candida albicans, in 60% a mixture of C. albicans and Staphylococcus aureus and in 20% S. aureus alone.
• Deficiency of iron, zinc or vitamin B may predispose a person to cheilitis. Particularly in the elderly and in vegetarians, vitamin B₁₂, folate, zinc, ferritin and transferrin receptor concentrations should be investigated in addition to the basic blood count.
• Other predisposing factors include e.g. Sjögren's syndrome, immunodeficiency conditions (e.g. HIV infection, chemotherapy or long-term glucocorticoid use), retinoids, diabetes, undernutrition, Down's syndrome, orofacial granulomatosis, retrognathism, smoking, and salivary retention caused by moustache.
• Treatment
  • Elimination of predisposing factors (e.g. correction of poor dental occlusion, treatment of oral yeast infection, correction of iron or vitamin B₁₂ deficiency).
  • A combination ointment of hydrocortisone, natamycin and neomycin sulphate, a combination of hydrocortisone and chlorhexidine, chlorhexidine gel

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Aged, Cheilitis, Child, Dental medicine, Dermatology, K13.0*, Lip, Mouth, actinic cheilitis, angle of the mouth, angle of the mouth ulceration, atopic cheilitis, rhagades