conditions angular-cheilitis

RECMG7793

Angular cheilitis

Condition:Angular cheilitis
Other:Cheilosis
ICD-10 Codes:K13.0

Naturopathic Treatments

Treat underlying nutrient deficiencies
vitamin B2 (riboflavin)
iron
vitamin B12
folic acid
zinc

Treat underlining infections
• candidiasis
• bacterial infection


Speed up healing
• pot marigold (Calendula officinalis) - topical vulnerary


Note: use appropriate antimicrobials if caused by infection (candida, herpes, etc)

Conventional Treatments

• topical antfungals
• topical antibiotics

Signs & Symptoms

• bilateral inflammation at the corner of the mouth
• often results in fissures (cracks) that may bleed or crust over
• nutrient depletion prevents proper cell replications and/or repair of tissue
• infection can cause irritation and prevent tissue repair

DDx

• cheilitis exfoliativa
• allergic contact cheilitis
• actinic cheilitis
• heilitis glandularis
vitamin B12 deficiency
vitamin B2 (riboflavin) deficiency
iron deficiency
• oral candidiasis
herpes simplex
• anorexia nervosa
• bulimia nervosa
• chapped lips
• hypervitaminosis A
• celiac disease

Pathogenesis

Nutrient deficiencies
vitamin B12 deficiency
iron deficiency

Infection
• oral candidiasis
• herpes

Side effects
• retinoids (isotretinoin)
Vitamin A (excess)

References

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Ross JA. Folic-acid deficiency as a cause of angular cheilosis. Lancet. 1971 Oct 16;2(7729):875. PubMed PMID: 4106897.

Rose JA. Folic-acid deficiency as a cause of angular cheilosis. Lancet. 1971 Aug 28;2(7722):453-4. PubMed PMID: 4105327.

Pontes HA, Neto NC, Ferreira KB, Fonseca FP, Vallinoto GM, Pontes FS, Pinto Ddos S Jr. Oral manifestations of vitamin B12 deficiency: a case report. J Can Dent Assoc. 2009 Sep;75(7):533-7. PubMed PMID: 19744365.

Wray D, Ferguson MM, Hutcheon WA, Dagg JH. Nutritional deficiencies in recurrent aphthae. J Oral Pathol. 1978;7(6):418-23. PubMed PMID: 105102.

Rademaker M. Adverse effects of isotretinoin: A retrospective review of 1743 patients started on isotretinoin. Australas J Dermatol. 2010 Nov;51(4):248-53. doi: 10.1111/j.1440-0960.2010.00657.x. PubMed PMID: 21198520.

Roveroni-Favaretto LH, Lodi KB, Almeida JD. Topical Calendula officinalis L. successfully treated exfoliative cheilitis: a case report. Cases J. 2009 Nov 23;2:9077. PubMed PMID: 20062714; PubMed Central PMCID: PMC2803874.

Sweeney MP, Bagg J, Fell GS, Yip B. The relationship between micronutrient depletion and oral health in geriatrics. J Oral Pathol Med. 1994 Apr;23(4):168-71. PubMed PMID: 8046654.

Ohman SC, DahlÉn G, MÖller A, Ohman A. Angular cheilitis: a clinical and microbial study. J Oral Pathol. 1986 Apr;15(4):213-7. PubMed PMID: 3088236.

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