Resumen
Definición
Angular cheilitis is inflammation of the angles of the mouth, characterized by fissures, scaling, erythema, and crusting.[1] The cause is usually multifactorial, due either to a primary infection or to a noninfectious entity such as mechanical irritation, nutritional deficiency, or other dermatologic condition.[2][Figure caption and citation for the preceding image starts]: Angular cheilitisFrom the collection of Dr Wanda C. Gonsalves; patient consent obtained [Citation ends].
[Figure caption and citation for the preceding image starts]: Angular cheilitisFrom the collection of Dr Wanda C. Gonsalves; patient consent obtained [Citation ends].
Anamnesis y examen
Principales factores de diagnóstico
- dentures with palatal erythema
- oral candidiasis
Otros factores de diagnóstico
- pruritus
- painful red fissures
- eczematous dermatitis of lower face
- specific medications
- history of inflammatory bowel disease
- history of acid reflux
- history of total parenteral nutrition
- history of eating disorders
- alopecia
- diarrhea/constipation
- bloody stool
- aphthous ulcers
- pale, depapillated atrophic tongue
- red, glossy, depapillated tongue
- red atrophic tongue
- reddish-purple depapillated tongue
- smooth, shiny red lips
- dental caries
- palatal erosions
Factores de riesgo
- age >75 years
- male sex
- dentures
- immune deficiency
- Down syndrome
- xerostomia
- chronic inflammatory skin disease
- diabetes mellitus
- Crohn disease
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- clinical diagnosis
Pruebas diagnósticas que deben considerarse
- fungal culture
- bacterial culture
- CBC
- serum iron panel
- serum vitamin B12
- serum folate
- serum zinc
- fasting plasma glucose
- HbA1c
- HIV test
- biopsy
- patch testing
Algoritmo de tratamiento
infectious etiology
noninfectious etiology
recalcitrant disease
Colaboradores
Autores
Wanda C. Gonsalves, MD
Professor and Vice Chair
Department of Family and Community Medicine
University of Kentucky College of Medicine
Lexington
KY
Divulgaciones
WCG declares that she has no competing interests.
Agradecimientos
Dr Wanda C. Gonsalves would like to gratefully acknowledge Dr Alison Bruce and Dr Kelly R. Tierney, previous contributors to this topic. AB and KRT declare that they have no competing interests.
Revisores por pares
Andrew D. Lee, MD
Resident
Department of Dermatology
Wake Forest University School of Medicine
Winston-Salem
NC
Divulgaciones
ADL declares that he has no competing interests.
Aisha Sethi, MD
Assistant Professor of Medicine
Associate Residency Program Director
University of Chicago
Chicago
IL
Divulgaciones
AS declares that she has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Rogers RS III, Bekic M. Diseases of the lips. Semin Cutan Med Surg. 1997 Dec;16(4):328-36. Resumen
Scully C, Bagan J-V, Eisen D, et al, eds. Angular cheilitis. Dermatology of the lips. Oxford, UK: Isis Medical; 2000:68-73.
The Primary Care Dermatology Society. Angular cheilitis (syn. angular stomatitis). Nov 2021 [internet publication].Texto completo
Schoenfeld RJ, Schoenfeld FI. Angular cheilitis. Cutis. 1977 Feb;19(2):213-6. Resumen
Artículos de referencia
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Diferenciales
- Herpes simplex infection
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