Angular cheilitis
Resumo
Definição
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].
História e exame físico
Principais fatores diagnósticos
- dentures with palatal erythema
- oral candidiasis
Outros fatores diagnósticos
- 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
Fatores de risco
- age >75 years
- male sex
- dentures
- immune deficiency
- Down syndrome
- xerostomia
- chronic inflammatory skin disease
- diabetes mellitus
- Crohn disease
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- clinical diagnosis
Investigações a serem consideradas
- 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 tratamento
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
Disclosures
WCG declares that she has no competing interests.
Acknowledgements
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.
Peer reviewers
Andrew D. Lee, MD
Resident
Department of Dermatology
Wake Forest University School of Medicine
Winston-Salem
NC
Disclosures
ADL declares that he has no competing interests.
Aisha Sethi, MD
Assistant Professor of Medicine
Associate Residency Program Director
University of Chicago
Chicago
IL
Disclosures
AS declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Rogers RS III, Bekic M. Diseases of the lips. Semin Cutan Med Surg. 1997 Dec;16(4):328-36. Abstract
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].Full text
Schoenfeld RJ, Schoenfeld FI. Angular cheilitis. Cutis. 1977 Feb;19(2):213-6. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Herpes simplex infection
More Differentials
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