Information
Editors
Cheilitis
Angular cheilitis
- Often associated with edentulousness, dentures and overclosing of the mouth leading to an increased skin fold at the angle of the mouth (pictures 1 2). 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
Angular cheilitis in children
- 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 granulomatosis may be associated with granulomatous and HIV infection with exfoliative cheilitis.
- Retinoids may, while drying the lips, predispose to cheilitis.
- See also perioral dermatitis Perioral Dermatitis.