Angular Cheilitis (Perlèche)
- 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)
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)
- Drooling, thumb sucking, and lip licking in young children
- Medications causing dry mouth
- Maintaining good oral hygiene
- Proper denture fit
Commonly Associated Conditions
- Nutritional deficiencies
- Diabetes mellitus type 2
- Irritant or allergic reactions to oral hygiene products
- Irritant or allergic reactions to denture products
- Inflammatory bowel disease
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