Angular cheilitis - Oral Mucosal Lesion
Angular cheilitis affects 0.7% of individuals in the United States and is most commonly seen in children and adults aged 30-60 years.
Individuals who wear dentures that do not adequately support the facial musculature are prone to developing angular cheilitis. Patients will have accentuated folds at the corners of the mouth, leading to wicking of the saliva onto what is normally dry skin. The moist keratin acts as substrate that encourages fungal and bacterial growth.
Those who have undergone head and neck radiation, and those with diabetes mellitus (type 1 or type 2), immunosuppression, and depletion of normal oral flora (from prolonged antibiotic use) are prone to developing oral candidiasis, including angular cheilitis.
Angular cheilitis is also seen in the setting of iron; vitamin B2, B3, B6, or B12; zinc; and folate deficiency, although these represent a much less common cause of angular cheilitis.
Angular cheilitis is reported to be more common in individuals with inflammatory bowel disease (Crohn disease and ulcerative colitis), orofacial granulomatosis, and Sjögren syndrome.
Related topics: actinic cheilitis, cheilitis, exfoliative cheilitis, granulomatous cheilitis
K13.0 – Diseases of lips
266429005 – Angular cheilitis
Differential Diagnosis & Pitfalls
- Herpes simplex virus (HSV) infection – Usually not bilateral as angular cheilitis typically is.
- Lip-licking dermatitis – More diffuse involvement of the lips.
- Secondary syphilis – "Split papules" may affect the angles of the mouth; other signs of secondary syphilis would be present as well.
- Plummer-Vinson syndrome – This severe iron deficiency should also be associated with fatigue, shortness of breath, etc.
- Atopic dermatitis
- Seborrheic dermatitis
- Allergic contact cheilitis
- Irritant contact cheilitis
- Actinic cheilitis
- Cheilitis glandularis
Drug Reaction Data