Angular Cheilitis (Perlèche)
Basics
Description
- Erythema, moist maceration, ulceration, and crusting at the corners of the mouth
- Three main types: irritant, allergic, and infectious
- Also known as perlèche, angular cheilosis, commissural cheilitis, and angular stomatitis
Epidemiology
Incidence
- Most common in 3rd, 5th, and 6th decades of life (1)
- Present in up to 25% of Down syndrome patients (1)
Prevalence
Etiology and Pathophysiology
- Decreased vertical dimension of the mouth, especially in elderly (1)
- Xerostomia or excessive moisture around the mouth
- Candida albicans is found in up to 93% of cases (1).
- Staphylococcus aureus is found in up to 63% of cases; MRSA is most common (1).
- Iron deficiency is found in up to 25% of cases (2).
- Frequently related to niacin deficiency, known as pellagra (2)
- Can be triggered by deficiencies of vitamins B2 (riboflavin), B6 (pyridoxine), B12 (cyanocobalamin), folic acid, or zinc (2)
Risk Factors
- Dentures
- Drooling, thumb sucking, and lip licking in young children
- Medications causing dry mouth
- Immunodeficiency
General Prevention
- Maintaining good oral hygiene
- Proper denture fit
Commonly Associated Conditions
- Nutritional deficiencies
- Diabetes mellitus type 2
- Immunodeficiency
- Irritant or allergic reactions to oral hygiene products
- Irritant or allergic reactions to denture products
- Eczema
- Inflammatory bowel disease
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Citation
Domino, Frank J., et al., editors. "Angular Cheilitis (Perlèche)." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816476/all/Angular_Cheilitis__Perlèche_.
Angular Cheilitis (Perlèche). In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816476/all/Angular_Cheilitis__Perlèche_. Accessed December 10, 2024.
Angular Cheilitis (Perlèche). (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816476/all/Angular_Cheilitis__Perlèche_
Angular Cheilitis (Perlèche) [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 10]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816476/all/Angular_Cheilitis__Perlèche_.
* Article titles in AMA citation format should be in sentence-case
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T1 - Angular Cheilitis (Perlèche)
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BT - 5-Minute Clinical Consult, Updating
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