Differential Diagnosis for Angular Stomatitis in a T2DM Patient
- Single most likely diagnosis
- B- Candidiasis: This is the most likely cause of angular stomatitis, especially in a patient with type 2 diabetes mellitus (T2DM). Candidiasis is a fungal infection that thrives in moist environments and is more common in individuals with diabetes due to their potentially compromised immune status and higher glucose levels in saliva and mucous membranes, which can facilitate fungal growth.
- Other Likely diagnoses
- A- Vitamin Def: Vitamin deficiencies, particularly of riboflavin (B2), can cause angular stomatitis. Given that patients with T2DM may have dietary restrictions or poor absorption of nutrients, a vitamin deficiency is a plausible cause.
- C- Bacterial infection: Though less common than candidiasis, bacterial infections can also lead to angular stomatitis. In a T2DM patient, the risk of bacterial infections may be increased due to impaired immune function.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lymphoma or other malignancies: Although rare, angular stomatitis can be a presenting sign of lymphoma or other malignancies. In a patient with T2DM, who may already be at increased risk for various complications, missing a diagnosis of cancer could have severe consequences.
- Sjögren's syndrome or other autoimmune diseases: These conditions can cause oral manifestations, including angular stomatitis, and are important to diagnose due to their systemic implications and the need for specific management.
- Rare diagnoses
- Contact dermatitis: This could be a rare cause of angular stomatitis, particularly if the patient has an allergic reaction to dental materials, oral care products, or certain foods.
- Iron deficiency: Similar to vitamin deficiencies, iron deficiency can lead to angular stomatitis, though it is less commonly associated with this condition compared to vitamin B2 deficiency.