From the Guidelines
Angular cheilitis is primarily caused by a combination of factors including moisture accumulation, nutritional deficiencies, and microbial infections, with fungal infections like Candida being a common cause, as seen in patients with HIV infection or AIDS 1. The causes of angular cheilitis can be multifactorial, including:
- Moisture accumulation at the corners of the mouth, which can be due to various factors such as saliva buildup, deep wrinkles, or habitual licking of the lips
- Nutritional deficiencies, particularly of iron, B vitamins, and zinc, which can significantly contribute to its development
- Microbial infections, with fungal infections like Candida albicans being a common cause, especially in immunocompromised patients, as described in the context of HIV infection or AIDS 1
- Bacterial infections like Staphylococcus aureus or Streptococcus, which can also colonize the affected areas Other contributing factors may include:
- Immune system disorders
- Certain medications that cause dry mouth
- Skin conditions like eczema or psoriasis It is essential to address the underlying cause of angular cheilitis, maintain good oral hygiene, and apply appropriate treatments, such as antifungal creams or antibiotics, to manage the condition effectively. In the context of HIV infection or AIDS, it is crucial to consider the possibility of opportunistic infections like Candida, as highlighted in the escmid guideline for the diagnosis and management of Candida diseases 2012 1.
From the Research
Causes of Angular Cheilitis
The causes of angular cheilitis are multifaceted and can be attributed to various factors, including:
- Bacterial and fungal components, with Candida albicans being a primary etiologic agent 2
- Systemic immune suppression, local irritation, and moisture 3
- Nutritional deficiencies and reduced vertical dimension of occlusion 2
- Systemic factors such as diabetes mellitus, pernicious anemia, and AIDS, which can compromise the host's immune system 4
- Advanced age and female gender, which can be mild predisposing factors 4
- Local factors such as decreased salivation and the wearing of dentures 4
Fungal Infections
Fungal infections, particularly those caused by Candida albicans, play a significant role in the development of angular cheilitis:
- Candida albicans is an oral commensal in as many as 40% to 65% of healthy adult mouths 4
- The fungus can infect the oral mucosa, especially in compromised hosts, and can lead to various clinical forms of oral candidiasis, including angular cheilitis 4
- Diagnostic confirmation of Candida albicans infection often relies on successful response to antifungal medications, culturing the offending microbe, or microscopic demonstration of fungal hyphae 4
Other Factors
Other factors that can contribute to the development of angular cheilitis include: