Angular Cheilitis

Angular cheilitis is an acute or chronic inflammation of the skin and contiguous labial mucosa located at the lateral commissures of the mouth.  Lesions are most often bilateral and may be painful. It is caused by excessive moisture and maceration from saliva and secondary infection with Candida albicans or less commonly with Staphylococcus aureus.  Drooling, thumb sucking, and lip licking are frequent causes of angular cheilitis in young children.

Less common causes include nutritional deficiencies, such as folic acid, zinc, B6/pyridoxine, riboflavin or niacin deficiency.

Diagnosis is clinical however potassium hydroxide (KOH) preparation from lesions and oral mucosa may be needed to confirm or rule out Candida & skin swab for staphylococcal  infection in recurrent cheilitis can be considered.

Treatment —

  • Maintaining optimal oral hygiene
  • Use of barrier creams (Zinc Oxide paste) or petrolatum
  • Positive KOH preparation- topical antifungal therapy (eg, miconazole, clotrimazole) ointment applied two times per day for one to three weeks and repeated as necessary
  • For Staphylococcal infection topical mupirocin ointment two times a day for 7 to 14 days.Once healed, a barrier cream or petrolatum applied nightly can help protect the skin from moisture. 

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