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TuulaSalo
MariaSiponen

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.