Overview
Angular cheilitis, also known as perleche, is an inflammatory condition affecting the corners of the mouth, often associated with fungal overgrowth, particularly Candida species. However, iron deficiency may also predispose individuals, especially women of child-bearing age, to this condition 2.Diagnosis
Clinical presentation includes erythema, fissuring, and sometimes ulceration at the commissures 2.
Consider iron deficiency in the differential diagnosis, particularly in women of child-bearing age 2.
No specific diagnostic tests are universally recommended; clinical assessment is key 2.Management
First-line treatments: Address underlying causes, such as correcting iron deficiency with iron supplementation 2.
Antifungal agents: May be used for confirmed Candida infections; specific drug classes include topical antifungals like nystatin or clotrimazole 2.
Adjunctive measures: Maintain oral hygiene, avoid lip irritants (e.g., spicy foods, ill-fitting dentures), and use protective lip balms 2.Special Populations
Pregnancy: Iron deficiency should be considered and treated with iron supplementation if diagnosed 2.
Comorbidities: No specific guidance provided in the abstracts; focus on managing underlying conditions like iron deficiency 2.Key Recommendations
Evaluate for iron deficiency in patients, particularly women of child-bearing age, presenting with angular cheilitis 2 (Evidence: Moderate).
Correct iron deficiency with appropriate supplementation when identified 2 (Evidence: Moderate).
Consider antifungal therapy for confirmed Candida infections, alongside addressing predisposing factors 2 (Evidence: Moderate).References
1 Hamanishi C, Tanaka S, Tamura K, Fujio K. Correction of asymmetric physeal closure. Rotatory distraction in 3 cases. Acta orthopaedica Scandinavica 1990. link
2 Murphy NC, Bissada NF. Iron deficiency: an overlooked predisposing factor in angular cheilitis. Journal of the American Dental Association (1939) 1979. link