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
Declarações
WCG declares that she has no competing interests.
Agradecimentos
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
Andrew D. Lee, MD
Resident
Department of Dermatology
Wake Forest University School of Medicine
Winston-Salem
NC
Declarações
ADL declares that he has no competing interests.
Aisha Sethi, MD
Assistant Professor of Medicine
Associate Residency Program Director
University of Chicago
Chicago
IL
Declarações
AS declares that she has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Rogers RS III, Bekic M. Diseases of the lips. Semin Cutan Med Surg. 1997 Dec;16(4):328-36. Resumo
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. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Herpes simplex infection
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