Often associated with edentulousness, dentures and overclosing of the mouth leading to an increased skin fold at the angle of the mouth (pictures 12). Constantly pooling saliva at the skin fold creates an ideal environment for fungal and bacterial infections.
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 or vitamin B may predispose a person to cheilitis. Particularly in the elderly and in vegetarians, vitamin B12, folate and transferrin receptor concentrations should be investigated in addition to the basic blood count.
Other predisposing factors include e.g. immunodeficiency conditions and salivary retention caused by moustache.
Treatment
Elimination of predisposing factors (correction of poor dental occlusion, correction of iron or vitamin B12 deficiency).
Usually caused by atopic dermatitis, hardly ever by a fungal infection (pictures 34).
Cheilitis may persist if the skin of a child, predisposed to allergies, is in repeated contact with food allergens, e.g. vegetables or fruit. It is also advisable to go without sweets for a week or two.
Other forms of cheilitis
Actinic (solar) cheilitis is a skin change which increases the risk of cancer of the lower lip. It can be treated with liquid nitrogen cryotherapy or laser.
Crohn's disease and orofacial granulomatosismay be associated with granulomatous and HIV infection with exfoliative cheilitis.
Retinoids may, while drying the lips, predispose to cheilitis.