Mostrando entradas con la etiqueta Angular Cheilitis. Mostrar todas las entradas
Mostrando entradas con la etiqueta Angular Cheilitis. Mostrar todas las entradas

lunes, 18 de mayo de 2026

Angular Cheilitis in Children and Adults: Causes, Symptoms, and Treatment

Angular Cheilitis

Angular cheilitis (AC) is a common inflammatory disorder affecting one or both oral commissures. It is characterized by erythema, fissuring, crusting, and discomfort.

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The condition may affect both children and adults and is typically associated with Candida albicans, Staphylococcus aureus, nutritional deficiencies, saliva pooling, and systemic diseases. Accurate diagnosis and targeted treatment are essential to prevent recurrence and restore oral health.

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✅ Introduction
Angular cheilitis, also known as perlèche or angular stomatitis, is a multifactorial lesion localized at the corners of the mouth. Although often considered a minor condition, it can significantly impair eating, speaking, and oral hygiene. Predisposing factors differ by age group but commonly include local irritation, infection, and immunologic or nutritional disturbances.
Dentists play a crucial role in identifying the underlying etiology and implementing effective treatment strategies.

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✅ Etiology and Risk Factors

In Children
▪️ Frequent lip licking or thumb sucking
▪️ Excessive drooling
▪️ Malocclusion or open bite
▪️ Nutritional deficiencies (iron, folate, vitamin B12)
▪️ Atopic dermatitis
▪️ Immunosuppression

In Adults
▪️ Ill-fitting dentures
▪️ Reduced vertical dimension of occlusion
▪️ Xerostomia
▪️ Diabetes mellitus
▪️ Iron deficiency anemia
▪️ Vitamin B-complex deficiency
▪️ Smoking
▪️ Immunocompromised states, including HIV infection

Microbial Causes
▪️ Candida albicans
▪️ Staphylococcus aureus
▪️ Mixed bacterial-fungal infection

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✅ Clinical Signs and Symptoms

Signs
▪️ Erythema at one or both oral commissures
▪️ Linear fissures or cracks
▪️ Crusting or ulceration
▪️ Maceration of adjacent skin
▪️ White pseudomembranes in candidal cases

Symptoms
▪️ Burning sensation
▪️ Pain during mouth opening
▪️ Itching
▪️ Tenderness
▪️ Difficulty eating spicy or acidic foods

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✅ Diagnosis
Diagnosis is usually clinical and based on history and examination. Recurrent or refractory cases may require:

▪️ Microbiological culture
▪️ Complete blood count
▪️ Serum ferritin
▪️ Vitamin B12 and folate levels
▪️ Blood glucose testing

✅ Differential Diagnosis

📊 Summary Table: Differential Diagnosis of Angular Cheilitis

Condition Key Clinical Features Distinguishing Characteristics
Herpes Labialis Grouped vesicles that ulcerate and crust Usually preceded by tingling and affects the vermilion border
Atopic Dermatitis Dry, erythematous, pruritic skin lesions Associated with eczema on other body areas
Contact Dermatitis Redness, scaling, and irritation Linked to cosmetics, toothpaste, or allergens
Lichen Planus White reticular lesions with erosive areas Presence of Wickham striae in oral mucosa
Actinic Cheilitis Chronic scaling and atrophy of the lip Primarily affects the lower lip and is sun-related
✅ Treatment

Topical Antifungal Therapy
▪️ Clotrimazole 1% cream
▪️ Miconazole 2% cream
▪️ Nystatin ointment

Topical Antibiotics
▪️ Mupirocin for confirmed or suspected bacterial infection

Barrier Protection
▪️ Petroleum jelly or zinc oxide ointment to reduce saliva irritation

Correction of Predisposing Factors
▪️ Adjust or replace ill-fitting dentures
▪️ Restore lost vertical dimension
▪️ Treat xerostomia
▪️ Improve oral hygiene
▪️ Address lip licking habits

Nutritional Supplementation
▪️ Iron
▪️ Vitamin B12
▪️ Folate
▪️ Riboflavin

Systemic Treatment
Systemic antifungals may be indicated in severe or recurrent candidal infections.

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💬 Discussion
Angular cheilitis is a multifactorial disease, and successful management requires treatment of both the lesion and its underlying cause. In children, habitual behaviors and drooling are predominant factors, whereas in adults, denture-related issues and systemic diseases are more common. Failure to investigate nutritional deficiencies or metabolic disorders often leads to recurrence.
Mixed infections involving Candida albicans and Staphylococcus aureus are particularly frequent, supporting the use of combination therapy when clinically indicated.

🎯 Clinical Recommendations
▪️ Evaluate for local and systemic contributing factors.
▪️ Assess denture fit and occlusal vertical dimension in adults.
▪️ Investigate iron and vitamin deficiencies in recurrent cases.
▪️ Encourage habit control in pediatric patients.
▪️ Use barrier ointments to protect the oral commissures.
▪️ Reassess lesions that persist beyond 2–3 weeks.

✍️ Conclusion
Angular cheilitis is a common but often recurrent condition affecting both children and adults. Effective treatment depends on identifying infectious, nutritional, mechanical, and systemic etiologies. With appropriate diagnosis and targeted therapy, most patients experience rapid symptom resolution and long-term prevention of recurrence.

📚 References

✔ Park, K. K., & Brodell, R. T. (2011). Angular cheilitis, part 1: Local etiologies. Cutis, 87(6), 289–295.
✔ Brodell, R. T., & Park, K. K. (2011). Angular cheilitis, part 2: Nutritional, systemic, and drug-related causes and treatment. Cutis, 88(1), 27–32.
✔ Gonsalves, W. C., Chi, A. C., & Neville, B. W. (2007). Common oral lesions: Part I. Superficial mucosal lesions. American Family Physician, 75(4), 501–507.
✔ Lalla, R. V., Patton, L. L., & Dongari-Bagtzoglou, A. (2013). Oral candidiasis: Pathogenesis, clinical presentation, diagnosis and treatment strategies. Journal of the California Dental Association, 41(4), 263–268.

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domingo, 1 de marzo de 2026

Angular Cheilitis or Herpes? How to Tell the Difference – A Practical Oral Health Guide

Angular Cheilitis - Herpes

Cracks or sores at the corners of the mouth are common and often confusing. Many people ask whether they have angular cheilitis or oral herpes (cold sores). Although both conditions affect the lips, they have different causes, appearances, and treatments.

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This guide explains the differences in clear, simple language while maintaining scientific accuracy. Understanding the distinction helps ensure proper care and prevents unnecessary medication use.

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✅ What Is Angular Cheilitis?
Angular cheilitis is inflammation at one or both corners of the mouth. It is not caused by a virus. Instead, it usually develops when moisture collects in the skin folds at the lip corners, allowing fungi or bacteria to grow.

Common Causes
▪️ Saliva pooling at the corners of the mouth
▪️ Ill-fitting dentures
▪️ Lip licking or drooling
▪️ Nutritional deficiencies (iron, vitamin B12)
▪️ Weakened immune system
The most frequent microorganisms involved include Candida albicans and Staphylococcus aureus.

Typical Symptoms
▪️ Redness and cracks at the lip corners
▪️ Burning or soreness
▪️ White or softened skin in the area
▪️ Mild bleeding when opening the mouth
Angular cheilitis is not contagious.

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✅ What Is Oral Herpes (Cold Sores)?
Oral herpes is caused by the herpes simplex virus type 1 (HSV-1). Once infected, the virus remains in the body in a dormant state and may reactivate during stress, illness, or sun exposure.
According to the World Health Organization, HSV-1 infection is highly prevalent worldwide.

Typical Symptoms
▪️ Tingling or burning sensation before lesions appear
▪️ Small fluid-filled blisters
▪️ Clusters of painful sores
▪️ Crusting after the blisters break
▪️ Possible fever or swollen lymph nodes (especially in first infection)
Oral herpes is contagious, particularly during active blister stages.

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✅ How to Differentiate Them at Home

Consider the Location
If the lesion is limited strictly to the mouth corners and appears as a crack, it is more likely angular cheilitis.
If you see small grouped blisters, especially on the lip border, it is more consistent with herpes simplex infection.

Notice the Sensation Before It Appears
A tingling or burning feeling before sores develop strongly suggests herpes.

Evaluate Recurrence Pattern
Repeated outbreaks in the same spot, triggered by stress or fever, are typical of herpes.

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✅ Treatment Differences

Treatment for Angular Cheilitis
▪️ Topical antifungal cream (if fungal cause suspected)
▪️ Mild antibacterial ointment
▪️ Lip barrier protection (petroleum jelly or zinc oxide)
▪️ Correction of denture fit if applicable
▪️ Evaluation of possible nutritional deficiencies

Treatment for Oral Herpes
▪️ Topical or oral antiviral medication (e.g., acyclovir)
▪️ Early treatment during tingling stage improves results
▪️ Avoid close contact during active lesions
The American Academy of Oral and Maxillofacial Pathology emphasizes proper diagnosis before starting antiviral therapy.

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💬 Discussion
Although both conditions affect the lips, they are biologically different. Misdiagnosing angular cheilitis as herpes may lead to unnecessary antiviral use. Conversely, assuming herpes is simple irritation may delay effective treatment and increase transmission risk.
Careful evaluation of lesion appearance, symptoms before onset, and recurrence history usually allows correct identification. When uncertainty exists, professional dental or medical evaluation is recommended.

🎯 Recommendations
▪️ Do not self-medicate with antivirals unless herpes is strongly suspected.
▪️ Keep the lip corners dry and protected if angular cheilitis is likely.
▪️ Seek professional evaluation if lesions persist longer than two weeks.
▪️ Maintain balanced nutrition to prevent deficiency-related angular cheilitis.
▪️ Avoid sharing utensils or close contact during active herpes outbreaks.

✍️ Conclusion
Angular cheilitis and oral herpes are distinct conditions with different causes, treatments, and levels of contagion. Angular cheilitis presents as cracks at the lip corners and is usually linked to moisture and fungal or bacterial growth. Oral herpes presents as painful fluid-filled blisters caused by HSV-1 and is contagious.
Recognizing the differences ensures appropriate treatment, reduces discomfort, and prevents unnecessary medication use.

📊 Comparative Table: Angular Cheilitis vs. Oral Herpes

Clinical Feature Angular Cheilitis Oral Herpes (HSV-1)
Primary Cause Fungal or bacterial overgrowth due to moisture Herpes simplex virus type 1 infection
Typical Location Corners of the mouth only Lips, lip border, sometimes inside lips
Lesion Appearance Cracks, redness, fissures Clusters of fluid-filled blisters
Contagious No Yes, especially during active outbreak
Standard Treatment Topical antifungal or antibacterial cream Antiviral medication (topical or oral)
📚 References

✔ American Academy of Oral and Maxillofacial Pathology. (2020). Clinical practice guidelines for the diagnosis of oral mucosal diseases. AAOMP.
✔ Arduino, P. G., & Porter, S. R. (2008). Herpes simplex virus type 1 infection: Overview on relevant clinico-pathological features. Journal of Oral Pathology & Medicine, 37(2), 107–121. https://doi.org/10.1111/j.1600-0714.2007.00586.x
✔ Scully, C., & Felix, D. H. (2005). Oral medicine — Update for the dental practitioner: Angular cheilitis. British Dental Journal, 199(9), 567–572. https://doi.org/10.1038/sj.bdj.4812887
✔ World Health Organization. (2022). Herpes simplex virus fact sheet. Geneva: WHO.

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sábado, 19 de septiembre de 2020

Angular Cheilitis: Why It Happens and How to Treat It

Angular Cheilitis

Angular cheilitis is an inflammatory condition that causes redness, cracks, and soreness at one or both corners of the mouth. It may make eating, speaking, and opening the mouth uncomfortable.

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Although it is often associated with fungal infections, angular cheilitis can develop for several reasons, including saliva exposure, skin irritation, bacterial or fungal growth, nutritional deficiencies, and poorly fitting dentures. Identifying the underlying cause is essential for effective treatment (Park et al., 2011a, 2011b).

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✅ What Causes Angular Cheilitis?
The corners of the mouth are exposed to repeated movement and moisture. When saliva remains trapped in these areas, the skin can become irritated and more vulnerable to infection.

The main causes and contributing factors include:
▪️ Excess saliva and lip licking: Persistent moisture damages the skin barrier and promotes inflammation.
▪️ Fungal infection: Candida albicans, a fungus that can naturally live in the mouth, may contribute to the condition.
▪️ Bacterial infection: Staphylococcus aureus is another possible cause, sometimes occurring alongside fungal infection.
▪️ Nutritional deficiencies: Low levels of iron, vitamin B12, folate, or certain B vitamins may contribute, particularly in recurrent cases.
▪️ Dental and anatomical factors: Poorly fitting dentures, reduced facial support, and deep folds at the mouth corners can encourage saliva accumulation.
▪️ Underlying health conditions: Diabetes, dry mouth, and certain skin or inflammatory disorders may increase susceptibility.
▪️ Medications and irritation: Treatments that cause dry, cracked lips, such as oral retinoids, may increase the risk. Contact allergies to oral care or cosmetic products can also contribute.

These factors may occur individually or together; therefore, angular cheilitis should not automatically be assumed to be a fungal infection (Hermann, 2022; Park et al., 2011a, 2011b).

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✅ What Are the Common Signs and Symptoms?
Typical clinical features include:

▪️ Cracks or fissures at the corners of the mouth.
▪️ Redness, soreness, or burning.
▪️ Pain when opening the mouth, eating, or speaking.
▪️ Crusting, bleeding, or occasional oozing.
▪️ Persistent irritation on one or both sides.

The condition is usually diagnosed through a clinical examination and medical history. If it persists or repeatedly returns, a clinician may consider a swab to identify microorganisms or blood tests to investigate possible nutritional deficiencies or underlying disease.

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✅ How Is Angular Cheilitis Treated?
Treatment depends on the cause. General care may be sufficient for mild cases, while persistent or infected lesions may require targeted therapy.
Cause How it contributes
Saliva accumulation Irritates and weakens the skin barrier.
Fungal or bacterial infection May contribute to inflammation and delayed healing.
Nutritional deficiencies May impair normal skin and mucosal health.
Poorly fitting dentures Can increase skin folding and saliva retention.
Important: Antifungal creams, antibiotics, and corticosteroids are not interchangeable. They should be selected according to the suspected cause and clinical findings. Avoid using combination creams without professional advice.
Most uncomplicated cases improve with appropriate care. However, persistent or recurrent angular cheilitis requires reassessment rather than repeated empirical treatment (Cabras et al., 2020).

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💬 Discussion
Angular cheilitis is a multifactorial condition in which local irritation, moisture, infection, and systemic factors can interact. Although Candida and bacteria may be involved, detecting a microorganism does not always establish that it is the primary cause.
Cabras et al. (2020) highlighted the limited quality of clinical trial evidence supporting many available treatments. Consequently, management should prioritize identifying and correcting the underlying cause rather than relying exclusively on medication.
For dental professionals, examining saliva pooling, denture stability, oral hygiene, and the condition of the surrounding tissues can help guide treatment and reduce recurrence.

✍️ Conclusion
Angular cheilitis develops when the skin at the corners of the mouth becomes inflamed, commonly because of prolonged moisture and irritation, sometimes combined with fungal or bacterial infection. Nutritional deficiencies, dental factors, and underlying medical conditions may also contribute.
The most effective approach is to protect the affected skin, address the underlying cause, and use medication only when indicated. Persistent, recurrent, or worsening lesions should be professionally evaluated.

🎯 Clinical Recommendations
▪️ Begin with a focused assessment of local irritation, saliva accumulation, oral health, and denture fit.
▪️ If lesions persist or recur, investigate relevant nutritional deficiencies, diabetes, and other contributing conditions according to the clinical history.
▪️ Obtain microbiological testing when the diagnosis is uncertain or treatment has failed.
▪️ Refer for further evaluation if a lesion is persistent, atypical, or fails to heal, particularly when it is unilateral or associated with induration.

📚 References
✔ Cabras, M., Gambino, A., Broccoletti, R., Lodi, G., & Arduino, P. G. (2020). Treatment of angular cheilitis: A narrative review and authors’ clinical experience. Oral Diseases, 26(6), 1107–1115. https://doi.org/10.1111/odi.13183
✔ Hermann, Z. S. (2022, September). Angular cheilitis. DermNet. https://dermnetnz.org/topics/angular-cheilitis
✔ Park, K. K., Brodell, R. T., & Helms, S. E. (2011a). Angular cheilitis, part 1: Local etiologies. Cutis, 87(6), 289–295. https://pubmed.ncbi.nlm.nih.gov/21838086/
✔ Park, K. K., Brodell, R. T., & Helms, S. E. (2011b). Angular cheilitis, part 2: Nutritional, systemic, and drug-related causes and treatment. Cutis, 88(1), 27–32. https://pubmed.ncbi.nlm.nih.gov/21877503/

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martes, 18 de agosto de 2020

Management of Angular Cheilitis in Children

Angular Cheilitis

Angular cheilitis in children is an inflammatory condition affecting one or both oral commissures. It typically presents as erythema, fissuring, maceration, crusting, or tenderness at the corners of the mouth.

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Although the condition is often associated with Candida species and Staphylococcus aureus, its development is usually multifactorial. Salivary pooling, lip licking, drooling, atopic dermatitis, nutritional deficiencies, and local mechanical factors can contribute to persistent inflammation.

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In pediatric patients, management should therefore address both the lesion and its predisposing factors, rather than relying exclusively on antimicrobial treatment.

✅ Common Causes and Predisposing Factors
Angular cheilitis frequently develops when moisture and maceration compromise the skin at the oral commissures. Secondary infection may then occur.
Factor Clinical Relevance
Saliva and drooling Persistent moisture promotes maceration and inflammation.
Lip licking Repeated wetting and drying can damage the commissural skin.
Candida species A common fungal contributor, particularly when oral candidiasis is also present.
Staphylococcus aureus An important bacterial cause or co-pathogen in pediatric lesions.
Atopic or seborrheic dermatitis May increase susceptibility to commissural inflammation and secondary infection.
Nutritional deficiencies Iron, riboflavin, folate, vitamin B12, and zinc deficiencies may be associated with recurrent disease.
Local anatomical or dental factors Deep commissural folds, malocclusion, or other factors promoting saliva retention may contribute.
Systemic disease Persistent or recurrent lesions may warrant evaluation for conditions such as immunodeficiency, diabetes, celiac disease, or inflammatory bowel disease.
These associations should be interpreted clinically rather than assuming that every child with angular cheilitis has an underlying nutritional or systemic disorder.

✅ Clinical Assessment
Diagnosis is primarily clinical. The examination should determine whether the lesions are unilateral or bilateral and identify erythema, fissures, crusting, ulceration, or exudation.
The oral cavity should also be examined for oral candidiasis, dental or orthodontic factors, excessive drooling, and other mucocutaneous abnormalities. Laboratory testing is generally unnecessary for an uncomplicated first episode.
Microbiological testing becomes more useful when the condition is persistent, recurrent, atypical, or unresponsive to initial therapy. A bacterial swab may help identify S. aureus, while fungal assessment can be considered when candidiasis is suspected.

Differential Diagnosis
Important conditions to consider include:

▪️ Herpes simplex infection, particularly when vesicles or a unilateral recurrent lesion are present.
▪️ Impetigo, especially when characteristic bacterial crusting is present.
▪️ Irritant or allergic contact cheilitis.
▪️ Atopic dermatitis.
▪️ Nutritional deficiency-related cheilitis.
▪️ Orofacial granulomatosis or inflammatory bowel disease when persistent lip swelling or additional oral/systemic findings are present.

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✅ Management of Angular Cheilitis in Children
Treatment should be individualized according to the suspected cause.

1. Protect the Commissures
A fundamental measure is reducing exposure to saliva and mechanical irritation. A protective barrier such as petrolatum can be applied to the affected commissures, particularly when drooling or lip licking contributes to maceration. The underlying behavior or source of excessive moisture should also be addressed.

2. Treat Suspected or Confirmed Candida Infection
When candidal involvement is suspected, a topical antifungal is generally appropriate.
Pediatric dental medication guidance from the American Academy of Pediatric Dentistry lists topical nystatin, clotrimazole, and miconazole among agents used for angular cheilitis. Treatment duration is commonly approximately 14 days or until complete healing, depending on the medication and clinical response.
If oral candidiasis is present simultaneously, it should also be treated; otherwise, the oral cavity may serve as a persistent reservoir for infection.

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3. Consider Bacterial Infection
When clinical findings or microbiological testing suggest staphylococcal infection, an appropriate topical antibacterial agent may be considered. Current antimicrobial guidance recommends microbiological evaluation when first-line management fails rather than repeatedly prescribing empiric antimicrobials.
Routine systemic antibiotics are not indicated for uncomplicated angular cheilitis.

4. Control Inflammation Carefully
A short course of a low-potency topical corticosteroid may sometimes be considered when marked inflammatory dermatitis accompanies infection. However, corticosteroids should not be used as monotherapy when an infectious cause is suspected, and prolonged use on facial skin should be avoided.

5. Investigate Recurrent or Persistent Disease
Failure to improve after appropriate initial management should prompt reassessment of the diagnosis and contributing factors. Depending on the clinical presentation, investigation may include:
▪️ Complete blood count and iron studies.
▪️ Ferritin.
▪️ Folate and vitamin B12.
▪️ Assessment of riboflavin or other nutritional deficiencies when clinically indicated.
▪️ Glucose evaluation when diabetes is suspected.
▪️ Microbiological testing.
▪️ Evaluation for immunodeficiency or gastrointestinal disease when supported by the clinical history.
Nutritional supplementation should be directed toward a documented or strongly suspected deficiency, rather than routinely prescribed to every child with angular cheilitis.

📊 Clinical Management of Angular Cheilitis in Children

Clinical situation Management approach
Saliva-related irritation Reduce lip licking and drooling; apply a protective barrier such as petrolatum.
Suspected Candida Use an age-appropriate topical antifungal and treat concomitant oral candidiasis when present.
Suspected bacterial infection Consider targeted topical antibacterial therapy, preferably guided by clinical findings or culture in persistent cases.
Marked inflammation A short course of low-potency corticosteroid may be considered with appropriate antimicrobial therapy when indicated.
Recurrent or refractory lesions Reassess the diagnosis, obtain microbiological testing when appropriate, and investigate nutritional or systemic factors.
💬 Discussion
The management of angular cheilitis in children is best approached as treatment of a multifactorial condition rather than as an isolated infection. Contemporary literature recognizes the frequent interaction between local moisture, mechanical irritation, Candida, and bacterial colonization. Consequently, antimicrobial therapy without correction of the local environment may result in incomplete resolution or recurrence.
The evidence base for specific treatments remains relatively limited compared with that available for other common pediatric oral conditions. A narrative review found that much of the published therapeutic evidence consists of older randomized trials, case series, and clinical experience. This supports a targeted approach in which treatment is guided by clinical presentation and response rather than indiscriminate use of multiple medications.
Persistent or recurrent angular cheilitis deserves particular attention because it can occasionally represent a manifestation of nutritional deficiency or systemic disease. In children with additional findings—such as persistent lip swelling, gastrointestinal symptoms, growth abnormalities, recurrent infections, or other mucosal lesions—broader medical evaluation may be appropriate.

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✍️ Conclusion
Angular cheilitis in children generally has a favorable prognosis when the underlying contributing factors are recognized and appropriately managed. Initial treatment should emphasize moisture control and barrier protection, with targeted topical antifungal or antibacterial therapy when infection is suspected. Persistent, recurrent, atypical, or treatment-resistant lesions require reassessment for alternative diagnoses and potential nutritional or systemic causes.

🎯 Clinical Recommendations
▪️ Prioritize barrier protection and control of saliva-related maceration in every child with angular cheilitis.
▪️ Examine the oral cavity for concurrent oral candidiasis and treat it when present.
▪️ Use topical antimicrobials according to the most likely or demonstrated infectious cause, avoiding unnecessary systemic antibiotics.
▪️ Avoid prolonged topical corticosteroid monotherapy on the facial skin.
▪️ Reassess lesions that do not improve after approximately 2 weeks of appropriate management.
▪️ Investigate recurrent disease for nutritional, dermatologic, dental, or systemic contributing factors rather than repeatedly prescribing empiric antimicrobials.

📚 References

✔ Brizuela, M., & Daley, J. O. (2026). Angular cheilitis. In StatPearls. StatPearls Publishing.
✔ Cabras, M., Gambino, A., Broccoletti, R., Lodi, G., & Arduino, P. G. (2020). Treatment of angular cheilitis: A narrative review and authors' clinical experience. Oral Diseases, 26(6), 1108–1114. https://doi.org/10.1111/odi.13183
✔ Chiriac, A., Chiriac, A. E., Pinteala, T., Spinei, A., Savin, L., Zelenkova, H., & Wollina, U. (2024). Angular cheilitis—An oral disease with many facets. Wiener Medizinische Wochenschrift, 174(15–16), 315–322. https://doi.org/10.1007/s10354-024-01037-9
✔ Narayanan, D., & Rogge, M. (2024). Cheilitis: A diagnostic algorithm and review of underlying etiologies. Dermatitis, 35(5), 431–442. https://doi.org/10.1089/derm.2023.0276
✔ Skinner, N., Junker, J. A., Flake, D., & Hoffman, R. (2005). Clinical inquiries: What is angular cheilitis and how is it treated? The Journal of Family Practice, 54(5), 470–471.
✔ Vasant, R., et al. (2009). Efficacy of fortification of school meals with ferrous glycine phosphate and riboflavin against anemia and angular stomatitis in schoolchildren. Food and Nutrition Bulletin, 30(3), 291–296. https://doi.org/10.1177/156482650903000307

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📌 Read and download the article: Management of Angular Cheilitis in children



° Fajriani, Fajriani. (2017). Management of Angular Cheilitis in children. Journal of Dentomaxillofacial Science. 2. 1. 10.15562/jdmfs.v2i1.461.