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Angular Cheilitis (Perlèche)

Melody A. Jordahl-Iafrato, MD, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Erythema, moist maceration, ulceration, and crusting at the corners of the mouth

  • Three main types: irritant, allergic, and infectious

  • Also known as perlèche, angular cheilosis, commiss...

DIAGNOSIS

HISTORY

  • Ask about location and duration of symptoms and possible contact with irritants.

  • Soreness, pain, burning, or pruritus can be present.

  • Ask about medications or recent exposures.

  • Review to...

TREATMENT

GENERAL MEASURES

  • Improve denture fit.

  • Improve oral hygiene, including denture care.

  • Treat dry mouth/sicca syndrome.

  • Avoid medications triggering dry mouth.

MEDICATION

First Line

  • For fungal infectio...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Good oral hygiene

  • Barrier cream at night if loss of vertical dimension of mouth

PATIENT EDUCATION

  • Use medications as directed.

  • Use barrier creams at night once healed...

REFERENCES

1
Park KK, Brodell RT, Helms SE. Angular cheilitis, part 1: local etiologies. Cutis.  2011;87(6):289–295.  [View Abstract]
2
Park KK, Brodell RT, Helms SE. Angular cheilitis, part 2: nutr...

CODES

ICD10

  • K13.0 Diseases of lips

  • B37.83 Candidal cheilitis

ICD9

528.5 Diseases of lips 

SNOMED

  • 266429005 Angular cheilitis (disorder)

  • 278521000 Candida angular cheilitis (disorder)

  • 707240008 Angular cheilit...

CLINICAL PEARLS

  • Diagnosis usually straightforward based on history and physical

  • Initial treatment should be either topical antifungals or antibiotics.

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