Angular Cheilitis
The medical condition that causes small sores at the corners of the mouth is called angular cheilitis (also known as angular cheilosis or perleche).
Clinical Presentation
Angular cheilitis manifests as erythematous (red), eroded lesions at one or both corners of the mouth, often with fissure formation, moist maceration, ulceration, and crusting 1, 2. The condition can present in four distinct clinical types, with Type I being the most common presentation 1.
Key Distinguishing Features
Unlike other oral ulcerations, angular cheilitis:
- Is specifically localized to the angles of the mouth bilaterally or unilaterally
- Does not present with vesicles (fluid-filled blisters)
- Shows characteristic radiating fissures from the mouth corners
- May be acute (erythematous or erosive with stinging) or chronic (erythemato-squamous, often asymptomatic) 3
Underlying Causes
The condition is typically multifactorial, involving:
Infectious agents (most common): In 82.5% of cases, microorganisms are isolated, including:
- Staphylococcus aureus (75.5% of positive cases) - shows profuse growth in both dentulous and edentulous patients
- Candida species (48.4%) - particularly C. albicans and C. stellastodia
- Streptococci (13.5%) 1
Local irritants: Physical, chemical, or mechanical factors
Allergic reactions: Contact dermatitis from various substances
Anatomical factors: Conditions that promote moisture accumulation at mouth corners 2, 3
Clinical Significance
This is distinct from recurrent aphthous ulcers (RAU), which present as well-demarcated, oval or round ulcers with white/yellow pseudomembranes and erythematous halos, typically occurring on non-keratinized oral mucosa rather than at the mouth corners 4.