What is the diagnosis and treatment for angular cheilitis?

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Last updated: April 7, 2025View editorial policy

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From the Guidelines

Angular cheilitis should be treated with an antifungal cream, such as clotrimazole 1% or miconazole 2%, applied 2-3 times daily for 7-14 days, alongside addressing underlying causes like nutritional deficiencies and maintaining good oral hygiene. To manage angular cheilitis, it is essential to apply an antifungal cream to the affected areas, as the condition can be caused by fungal infections, among other factors. The treatment should be accompanied by good oral hygiene practices and addressing any underlying nutritional deficiencies, such as those in B vitamins, iron, and zinc 1. Some key considerations in treating angular cheilitis include:

  • Applying a low-potency steroid cream like hydrocortisone 1% if there's significant inflammation
  • Using mupirocin 2% ointment for cases with bacterial infection
  • Keeping the area clean and dry
  • Avoiding licking the corners of the mouth
  • Applying petroleum jelly as a barrier after treatment It is crucial to address underlying causes, including denture-related issues, diabetes management, and nutritional deficiencies, to prevent recurrence of angular cheilitis. If symptoms persist beyond two weeks of treatment or recur frequently, consulting a healthcare provider is necessary to evaluate for any underlying systemic conditions 1.

From the Research

Definition and Characteristics of Angular Chelitis

  • Angular cheilitis (AC) is a clinical entity characterized by erythema, rhagades, ulcerations, and crusting of one or both lip commissures and perilabial skin, responsible for an unpleasant and painful discomfort 2.
  • It is a common condition characterized by erythema, moist maceration, ulceration, and crusting at the corners of the mouth 3.

Etiologies of Angular Chelitis

  • Local factors that act alone and in combination to produce AC include irritant, allergic, and infectious causes 3.
  • Systemic immune suppression, local irritation and moisture, fungal and/or bacterial infection can also contribute to the development of AC 4.
  • Nutritional, systemic, and drug-related factors may act exclusively or in combination with local factors to cause AC 5.

Treatment of Angular Chelitis

  • Antifungals are often used as the first-line treatment for AC, but there is limited scientific evidence to support their reliability 2.
  • Alternative topical treatments, such as 1% isoconazole nitrate (ISN) and 0.1% diflucortolone valerate (DFV) ointment, have been proposed as effective treatments for AC 2.
  • Identifying the underlying etiology of AC is a critical step in developing an effective treatment plan for this condition 3, 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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