Angular cheilitis

Question 1

What are the 4 broad causes of angular cheilitis?

Answer 1

Multifactorial:

• Infectious
• Mechanical
• Nutritional deficiency
• Chronic inflammatory Skin conditions

Question 2

What are the infectious causes?

Answer 2

Candida albicans and Staphylococcus aureus are often isolated alone or in combination.

• seen in people with DM, dentures, immune deficiency like HIV
• outbreaks in children due to staph/strep

Question 3

What are the non-infectious mechanical causes?

Answer 3

• habitual biting or licking the lip
• ill fitting dentures
• dry moth
• thumb sucking
• dental trauma, flossing, drooling

Question 4

What are the nutritional causes?

Answer 4

deficiencies of riboflavin, niacin, folate, iron, vitamin B12, and zinc, and general protein malnutrition, show evidence of causation. [2] [9] Eating disorders or a history of total parenteral nutrition can also be associated underlying factors.

Question 5

What are the chronic inflammatory skin condition causes?

Answer 5

Chronic inflammatory skin diseases: atopic dermatitis, perioral dermatitis, and allergic contact dermatitis at the commissures can cause angular cheilitis.
Crohn disease or orofacial granulomatosis

Question 6

What is the pathophysiology of angular cheilitis?

Answer 6

Maceration due to various etiologic factors leads to a disrupted epidermal barrier and provides an ideal environment for fungal and bacterial organisms. Edentulous patients experience bone resorption of the mandible, and this also results in sagging of the facial tissue and excessive folds at the commissures. Saliva accumulation and moisture trapping provide an ideal environment for secondary opportunistic infection.

Question 7

Significance of rash only one side of the mouth, versus bilateral cheilitis?

Answer 7

More likely due to a temporary condition if one sided. Bilateral more likely due to a chronic condition

Question 8

Redness of the palate in denture wearer signifies ?

Answer 8

Candida

Question 9

Nutritional deficiencies may affect the tongue: what do the following findings signify?

1-Depapillated pale tongue or aphthous ulcers
2-Depapillated glossy red tongue
3- Red atrophic tongue
4-A reddish-purple depapillated tongue

Answer 9

1- Iron deficiency
2- Folate or Niacin deficiency
3- vitamin B12 deficiency
4-riboflavin deficiency.(also causes smooth red lips)

Question 10

What deficiency is suggested by combination of angular cheilitis, alopecia, diarrhea and oral ulcers.

Answer 10

suggests a zinc deficiency.