Type your tag names separated by a space and hit enter

Angular Cheilitis (Perlèche)

Angular Cheilitis (Perlèche) is a topic covered in the 5-Minute Clinical Consult.

To view the entire topic, please or purchase a subscription.

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

Medicine Central

-- The first section of this topic is shown below --



  • 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


  • Most common in 3rd, 5th, and 6th decades of life (1)
  • Present in up to 25% of Down syndrome patients (1)

  • 0.7–3.8% of oral lesions in adults (1)
  • 0.2–15.1% of oral lesions in children (1)

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

-- To view the remaining sections of this topic, please or purchase a subscription --


Stephens, Mark B., et al., editors. "Angular Cheilitis (Perlèche)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816476/all/Angular_Cheilitis__Perlèche_.
Angular Cheilitis (Perlèche). In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816476/all/Angular_Cheilitis__Perlèche_. Accessed April 25, 2019.
Angular Cheilitis (Perlèche). (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816476/all/Angular_Cheilitis__Perlèche_
Angular Cheilitis (Perlèche) [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 25]. 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
TY - ELEC T1 - Angular Cheilitis (Perlèche) ID - 816476 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816476/all/Angular_Cheilitis__Perlèche_ PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -