Angular Stomatitis - Cheilitis
Related Subjects:
|Macroglossia
|Microstomia
|Glossitis
|Medical Teeth
|Gum hypertrophy
|Angular Stomatitis - Cheilitis
|Oral Aphthous Ulcers
|Oral Leukoplakia
👄 Stomatitis = inflammation of the mouth.
💋 Cheilitis = inflammation of the lip.
⚡ Angular stomatitis (angular cheilitis) = painful fissuring or cracking at the mouth corners (labial commissures).
Persistent lesions warrant referral to exclude malignancy. ⚠️
📖 About
- Common in elderly, especially those without teeth (edentulous) 🦷.
- Frequently secondary to candida infection in moist commissures.
🧪 Aetiology
- 🍞 Malnutrition/deficiency: B12, folate, iron, or B6 deficiency.
- 🦷 Poorly fitting dentures → saliva pooling & moisture retention.
- 🧴 Associated with seborrhoeic dermatitis and other skin conditions.
- 💊 Drug-related xerostomia may predispose to fissuring.
🧠 Clinical Features
- Cracks/fissures at mouth corners; may ulcerate.
- Red, sore, inflamed commissures.
- Pain worse on opening mouth or eating acidic/spicy foods.
🔎 Differential Diagnosis
- ⚠️ Oral cancer: persistent, indurated, non-healing, or nodular lesions require urgent referral (2-week rule).
🔬 Investigations
- Bloods if systemic cause suspected:
- 🩸 FBC: look for anaemia.
- 📈 ESR: if systemic inflammation suspected.
- 🧪 B12, Folate, Ferritin: check for megaloblastic/iron deficiency anaemia.
💊 Management
- 🦷 Dental care: adjust/replace dentures; ensure good fit.
- 🧴 Topical therapy: Vioform-Hydrocortisone cream (Hydrocortisone 1% + Clioquinol 3%) for inflammation ± Candida/staph infection.
- 🍽️ Nutrition: correct vitamin/mineral deficiencies (iron, folate, B12, B6).
- 🪥 Oral hygiene: maintain clean oral cavity; avoid irritants.
- Antifungal therapy (topical miconazole) if candidiasis suspected.
🌍 Teaching Pearl
- 👵 Classic case: elderly woman with dentures + iron deficiency → angular cheilitis.
- ✅ Treat both local infection and underlying deficiency for best results.
