A middle-aged woman presents to your office with soreness at the corners of her mouth for 4 months (Figure 32-1). On examination, she has cracking and fissures at the right corner of her mouth. She is diagnosed with angular cheilitis and treated with nonprescription nystatin ointment twice daily. Within 2 weeks she was fully healed.

Angular cheilitis is an inflammatory lesion of the commissure or corner of the lip characterized by scaling and fissuring.

Perlèche, angular cheilosis, commissural cheilitis, angular stomatitis

• Most common in the elderly. In one study of institutionalized elderly patients in Scotland, angular cheilitis was present in 25% of patients.1

• Maceration is the usual predisposing factor. Microorganisms, most often Candida albicans, can then invade the macerated area (Figure 32-2).2
  
• It may also occur in infants and children related to drooling, thumb sucking, and lip licking (Figure 32-3).
  
• Lip licking can cause a contact dermatitis to the saliva along with perlèche (Figure 32-4). Perlèche is derived from the French word, “lecher,” meaning to lick.
  
• Historically associated with vitamin B deficiency, which is rare in developed countries.