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angular cheilitis; rhagades; perleche; angular cheilosis
Chapping & fissuring of the corners of the lips.
Etiology:
1) anatomic predisposition
a) flaccid, sagging cheeks with deepened labial angles
b) lack of or ill-fitting dentures
1] constant retention of moisture in angles
2] secondary infection
2) nutritional deficiencies
a) riboflavin
b) iron deficiency
c) protein deficiency
3) any etiology of cheilitis may manifest as angular cheilitis
Clinical manifestations:
1) corners of mouth
a) erythema
b) wrinkled macerated skin
c) superficial exudative crusts
d) deep fissures not involving mucosal surface of commissures
2) riboflavin deficiency
a) glossitis
b) keratitis
c) dermatitis
Differential diagnosis:
- difference between angular stomatitis & angular cheilitis unclear
Management:
1) directed at specific etiology
2) see cheilitis
Related
angular stomatitis
General
cheilitis
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 63-65
- Sharon V, Fazel N.
Oral candidiasis and angular cheilitis.
Dermatol Ther. 2010 May-Jun;23(3):230-42
PMID: 20597942
- Medical Knowledge Self Assessment Program (MKSAP) 19
Board Basics. An Enhancement to MKSAP19.
American College of Physicians, Philadelphia 2022