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angular cheilitis

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Angular stomatitis describes erythema and maceration of the skin adjacent to the angle of the mouth. It is often seen in the elderly where it is predisposed to by sagging facial muscles and ill-fitting dentures which produce a fold in the angle of the mouth.

The most common cause is Candida infection but where there is crusting, secondary infection with Staphylococcal aureus must be considered.

Less common causes of angular stomatitis include:

  • contact allergy
  • atopic or seborrhoeic dermatitis
  • vitamin B deficiencies
  • iron deficiency

The treatment is dependent on the cause.

Empirical treatment is with the use of miconazole-hydrocortisone cream (daktacort) for 7 days - this combination will reduce inflammation and treat candida infection; also many gram positive bacteria including streptococci and staphylococci are sensitive to miconazole.

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