An Updated Overview of the Etiology Diagnosis and Management” by Anitha Krishnan Pandarathodiyil, Sukumaran Anil, and Srinivas Prasad Vijayan
Summary
This inflammatory condition, known for causing discomfort at the corners of the mouth, is examined in terms of its various causes, diagnostic considerations, and management strategies.
Introduction
Angular cheilitis, characterised by erythema, moist maceration, ulceration, and crusting at the mouth’s commissures, is identified as a multifactorial disorder.
The condition’s prevalence varies, affecting both adults and children, with specific types based on lesion characteristics.
The aetiological factors span from local issues like anatomical changes and mechanical irritation to systemic conditions, including nutritional deficiencies and systemic diseases.
Aetiologic Factors
The paper looks into both local and systemic aetiologies of AC, emphasising the multifaceted nature of its onset. Local factors encompass anatomical changes, such as reduced vertical dimension due to edentulism, mechanical irritations like habitual lip-licking, allergic reactions to dental materials, and microbial infections primarily by Candida albicans and Staphylococcus aureus. Systemically, nutritional deficiencies, particularly in iron and vitamin B complex, play a significant role alongside diseases like diabetes mellitus, xerostomia, and inflammatory bowel diseases, which can predispose individuals to AC.
Differential Diagnosis
AC’s differential diagnosis includes conditions that mimic its clinical presentation, such as herpes simplex infection, secondary syphilis, and various forms of cheilitis. Distinguishing AC from these conditions relies on careful clinical examination and consideration of the patient’s medical history.
Management Of Angular Cheilitis
Effective management of AC requires addressing both the local and systemic causes. Initial strategies focus on local care, including improving oral hygiene, addressing denture fit, and employing topical barriers to protect against maceration. Pharmacological interventions are tailored to the identified cause, with antifungals like nystatin and miconazole for fungal infections and mupirocin or fusidic acid for bacterial causes. For mixed infections, combinations of antimicrobials with hydrocortisone may be necessary. In cases where local treatment is ineffective, investigation into systemic factors is crucial, with treatments adjusted to address any identified nutritional deficiencies or underlying systemic conditions.
Conclusion
The paper concludes by emphasising the necessity of a comprehensive approach to diagnosing and managing angular cheilitis. Given its potential to indicate more severe systemic health issues, a thorough investigation into its aetiology is crucial. Successful management hinges on a multifaceted strategy that addresses local irritants and systemic health concerns, underscoring the importance of follow-up to evaluate treatment effectiveness.
Key Takeaways
- Angular cheilitis is a complex condition with multifactorial aetiology, requiring a holistic approach to diagnosis and management.
- Local factors such as anatomical changes, mechanical irritants, and microbial infections are significant contributors, alongside systemic conditions like nutritional deficiencies and systemic diseases.
- Effective management strategies must be multifaceted, addressing local and systemic causes and tailored pharmacological treatments based on the underlying aetiology.
- Given its potential indication of broader health issues, a careful and thorough evaluation is essential for successful resolution and patient well-being.
This paper highlights the importance of a comprehensive understanding of angular cheilitis, from its varied causes to the intricacies of its management. It underlines the need for healthcare professionals to adopt a nuanced approach in treating this condition.
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