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Rash at the corner of the mouth: Angular cheilitis.

Have you ever had that rash at the corners of your mouth and wonder, Why?

This rash is called Angular cheilitis also known as angular cheilosis, commissural cheilitis, angular stomatitis or perlèche (from the French term pourlècher [to lick one’s lips]).  This common condition affects children (up to 15% of mouth lesions in children and up to 3.8% of adults with mouth lesions) and peaks in the 3rd, 5th, and 6th decades of life.  The rash can come on suddenly or gradually and follow a pattern of worsening (relapse) and improving (remit).

There are many causes including:

Irritation (irritant contact dermatitis): irritation from saliva; this is especially common in persons with eczema

Allergies (allergic contact dermatitis): allergic reactions from common exposures including

  • Flavorings/Fragrances: lip gloss, lipstick, lip balm, lip liner, cosmetics, aftershave, cologne, perfume, toothpaste, chewing gum, foods, ice cream, cigarettes, soap, lotion liquors.
  • Metals:  Nickel in orthodontic devices, musical instruments, dentures, lipstick casing, pencils/pens; gold, mercury or palladium in tooth fillings, or cobalt or potassium dichromate  braces, bridges or retainers.
  • Other: Sunscreens, preservatives, antiseptics, medications, rubber products, glues, etc.

Infections:  The mouth is a common area to become colonized or even infected with Candida (yeast), and bacteria such as Staphylococcus aureus, (Staph) and beta-hemolytic Streptococci (Strep).  The Herpes simplex virus can reoccur at this site with small blisters that crust over.  Infection with HIV and syphilis can lead to angular cheilitis.

Nutritional: A variety of nutritional deficiencies can lead to symptoms that improve with nutrient replenishment.  Deficiencies of iron, B vitamins (B2, B6, B12), folic acid, Niacin and Zinc can be tested for and treated.

Systemic: Angular cheilitis is common in Down syndrome (25%), dry mouth (from dehydration, salivary gland infection, obstruction, tumor, mouth radiation, chemotherapy), diabetes, nerve problems, malnutrition (anorexia) and autoimmune disorders (Sjogrens, lupus, Crohns disease, ulcerative colitis).  There are syndromes (Plummer-Vinson syndrome) that frequently have angular stomatitis as a symptom.

Drug-Related:  Certain medications have been found to be the cause including isotretinoin (Retin A), and anti-viral medications for HIV/AIDS.  Drugs of abuse that have been implicated are cocaine, methamphetamine (“meth”) and heroin.

At Family Allergy & Asthma Care of Montana, we will assist you in finding the cause of your rash and develop a treatment plan.  We work closely with dermatologists to provide the best outcomes possible.

This information is solely for informational purposes and not intended as a substitute for consultation with a medical professional. 

 

  1. Marcus QueenMarcus Queen08-11-2014

    Thank you for this very informative and helpful article, you may help a lot of people suffering from Angular Cheilitis. Keep it up !

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