Angular Cheilitis - Pictures, Treatment, Symptoms, Causes
Angular Cheilitis Pictures
What is Angular Cheilitis?
Angular cheilitis is an inflammatory condition that involves the labial commissure or the corners of the mouth. It is a lip inflammatory condition that is characterized by inflammation accompanied with fissures and sores or lesion which can occur in either one or both corners of the mouth. It is not a serious or life-threatening condition but may signify an existing underlying condition. Angular cheilitis can also be annoying and discomforting and can also affect the cosmetic concern as the lesion is rather unsightly.
Angular cheilitis has been classified as a type of stomatitis. Stomatitis is the common term for inflammation of the mouth that can generally affect the ability to speak and eat and can also affect the pattern of sleeping. Angular cheilitis is among the type of stomatitis similar to cold sore which develops on or the surrounding area of the lips. This type of stomatitis is usually contagious from the time of its eruption until it is completely healed. It is also a type of stomatitis caused by a virus particularly Herpes simplex type 1.
Oral candidiasis is also another classification of angular cheilitis when it involves Candida. This angular cheilitis caused by Candida species is termed as "monilial perleche". Angular cheilitis on the other hand is known in various names such as angular stomatitis, angular cheilosis, commissural cheilitis or perleche.
Angular cheilitis is the most common form of fungal and bacterial infection of the lips that equally affects both men and women. It is a common inflammation of the lips prevalent in adults particularly those is the 3rd to 6th decade of life while it can also affect children. It is more common in people who wear dentures or have no natural teeth and prevalent in elderly people.
Angular cheilitis has various causes that the signs and symptoms also vary from one person to another depending on the causative factor that triggered the onset. The development of the lesion is the most common symptom of angular cheilitis although the appearance and severity also vary depending again on the cause of cheilitis. The lesions are usually symmetrical which may appear on either one or both corners of the lips. The lesion on the other hand may be confined in the mucosa of the lips only or it may also extend away from the vermilion border of the lips towards the facial skin.
The initial onset cheilitis is characterized by redness that surrounds the gray-white thickening corners of the mouth or of the affected site. The edema will follow the initial onset, which is accompanied by a triangular redness of either one or both corners of the lips. The edema is accompanied with softening and whitish discoloration of the affected site. The lesion will later have a fissure and ulceration along the mucosa of the lips. Bleeding is rather unusual although it may occur in some instances. On rare occasion, the skin inflammation may extend to the adjacent area of the skin such as the cheek or the chin. Pus formation is potential in chronic cases of angular cheilitis which may also be associated with granulation of tissue and possible scaling of the skin of the affected area.
The exact cause of angular cheilitis is rather vague although the disorder is regarded to be infectious in origin and influenced by multiple predisposing factors.
Angular cheilitis is caused by the following:
Infection from certain organisms most commonly with Candida species is among the infectious origin of cheilitis. Candida albicans is the usual culprit in the onset and this diploid fungus cultivate as yeast and filamentous cells. Candida albicans is also commensal and thrives in the gastrointestinal tract and mouth of humans. Majority of angular cheilitis are caused by Candida albicans infection.
Bacterial infection is also another factor that can trigger the onset of cheilitis. Staphylococcus aureus and B-hemolytic streptococci are the two bacteria that can cause the cheilitis.
Nutritional deficiency has also been implicated in the cause of angular cheilitis. This factor involves the deficiency in Vitamin B and iron. Nutritional deficiency is the most common cause of angular cheilitis in third world or developing countries. Iron deficiency on the other hand has no direct link with the onset of cheilitis but it is believed to diminish the capabilities of the immune system which can then allow the infection from Candida species. The nutritional deficiency is generally the result of malnutrition including the diet which does not include consumption of food containing Vitamin B. Nutritional deficiency may also be secondary to underlying conditions such as that of gastrointestinal disorders.
Contact irritant dermatitis
Contact irritant dermatitis is also comprised in the factors that cause angular cheilitis. Irritant contact dermatitis is characterized by damage to the skin surface more rapidly before the skin can able to repair the damage. Saliva drooling on the corners of the lips or that constantly come into contact with the lips is implicated in the onset of cheilitis. The saliva aids in the digestion process through its digestive enzyme composition. The digestive enzyme can harm the soft tissue of the lips particularly in the corners of the lips where much of the saliva is constantly pooling. The constant accumulation of the saliva within the corners of the mouth and its adjacent area can result to maceration which is potential for yeast growth and infection.
Systemic disorders such as gastrointestinal disorder can result to nutritional deficiency which in turn can trigger the onset of cheilitis. Orofacial granulomatosis is a disorder that causes the enlargement of the lips potential for the anatomical distortion or alteration that can also affect the corners of the mouth and later result to cheilitis.
Medication also contributes to the onset of cheilitis. There are certain medicines that have a side effect of dry lips which is potential for cheilitis.
Angular cheilitis may need not any treatment as it usually resolves on its own. Treatment however depends on the cause of cheilitis including the severity. Most cheilitis respond well to anti-fungal treatment.
Depending on the etiology of angular cheilitis the following treatment can be done to facilitate healing while preventing further complication:
- Antibiotics either topical or oral can be prescribed to treat cheilitis caused by bacterial infection.
- Antifungal cream applied topically
- Oral antifungal medication
- Steroid ointments
- Nutritional supplements to manage cheilitis caused by nutritional deficiency.
- Surgical implants and fillers may be recommended for severe cheilitis that has altered the anatomic appearance of the affected site.