Angular Cheilitis (Perleche)

• Associated with increased moisture (saliva) at commissures.
• Predisposing factors: Thumb sucking in children; chin furrows ("marionette lines"); oral candidiasis; dentures; isotretinoin treatment.
• Findings: Erythema and maceration at commissures (see Fig. 33-1).
• Diagnosis: Clinical diagnosis, consider KOH for candidiasis and culture for S. aureus, Candida.
• Management: Barrier cream, topical antifungal.