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What causes Angular cheilitis?

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Posted on Tue, 4 Feb 2014
Question: In a previous question, it was revealed to me by a dermatologist from this website that I had probably gotten a male yeast infection on my glans penis from sexual intercourse with my girlfriend, I was wondering if the same yeast infection has been the cause of Angular cheilitis (I think this is what it is. that has constantly been at the corners of my mouth? It has been recurrent for the last 6 months or so, has never healed and the corners of my mouth seem to be getting worse. I've also noticed my tongue always seems to be white in color. My girlfriend, was a virgin before we met, has also developed facial acne and reddish lines that protrude from the corners of her mouth. What is this? Medical History on me: anemia = Yes. Due to a field amputation of my right leg above the knee in 2009. Treated for infectious diseases. smoking = Yes, or at least occasional. the use of chewing tobacco = occasional. alcohol consumption = Yes. cutaneous disorders (atopic dermatitis, psoriasis, lichen planus): Not that I'm aware of. No medication taken.
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Answered by Dr. Kalpana Pathak (45 minutes later)
Brief Answer: it could be candidal infection Detailed Answer: Hi, Thanks for writing to us. Angular cheilitis can occur due to vitamn b deficiency( riboflavin), drooling of saliva,frequent licking of lip, yeast infection. A persistently white tongue or tongue covered with white slough points towards yeast infection. However leucoplakia which is associated with smoking and tobacco should also be ruled out. Also yeast infection is common with decreased immunity, use of steroids, antibiotics, chronic illness, diabetes etc Though candidal balanoposthitis is sexually transmitted but can occur otherwise also without contact. So if your girl friend has no such symptoms or she developed symptoms later then probably you didn't get it from her. Usually in oral candidal infection, oral fluconazole 200mg daily or 150 mg stat dose and 100mg daily dose for 10 days helps. Plain angular cheilitis would respond to topical steroid antifungal cream. You should also take oral b complex vitamin for few days. I can only comment upon your girl friend's condition, if you could attach images of her face. Hoping to hear fron you soon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kalpana Pathak (1 hour later)
Hmmm, thank you. I have uploaded a picture of my tongue if that helps at all. I won't be able to get a picture of her face at the moment because she is at work. Before the onset of Angular cheilitis, I had a cold sore (or what I thought was a cold sore) on my lip and each day I was smoking a large amount of marijuana. Smoking in general lowers immunity, correct? Since the Angular cheilitis appeared, I have been taking B Complex vitamins daily and seen no improvement.
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Answered by Dr. Kalpana Pathak (34 hours later)
Brief Answer: Details below Detailed Answer: Hi, Thanks for writing back. I have seen the pics attached. Unfortunately its not a clear resolution image as though your tongue appears white, I can't appreciate whether it is due to whitish slough or pallor. In candidal infection, there is whitish slough over tongue and when tried to remove can lead red sore bleeding points. You will have this feeling that your tongue is coated with some white thick curdy material. In anemia too tongue can appear white but it's the pinkish color of the tongue that diminishes due to reduced hemoglobin. So I would like to know, if as such you feel its the color of your tongue that has become whitish or pale or you feel that your tongue is coated with white material. Smoking reduces immunity, that's true. Angular cheilitis as I mentioned earlier can occur in vitamin b complex deficiency, eczema, frequent licking of corners of mouth or infection. So simply taking b complex might not help. We have to rule out other factors too. If its oral thrush or candidal infection, a course of oral antifungal will be required as mentioned earlier. Hope this helped you out. Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Kalpana Pathak

Dermatologist

Practicing since :2006

Answered : 2014 Questions

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What causes Angular cheilitis?

Brief Answer: it could be candidal infection Detailed Answer: Hi, Thanks for writing to us. Angular cheilitis can occur due to vitamn b deficiency( riboflavin), drooling of saliva,frequent licking of lip, yeast infection. A persistently white tongue or tongue covered with white slough points towards yeast infection. However leucoplakia which is associated with smoking and tobacco should also be ruled out. Also yeast infection is common with decreased immunity, use of steroids, antibiotics, chronic illness, diabetes etc Though candidal balanoposthitis is sexually transmitted but can occur otherwise also without contact. So if your girl friend has no such symptoms or she developed symptoms later then probably you didn't get it from her. Usually in oral candidal infection, oral fluconazole 200mg daily or 150 mg stat dose and 100mg daily dose for 10 days helps. Plain angular cheilitis would respond to topical steroid antifungal cream. You should also take oral b complex vitamin for few days. I can only comment upon your girl friend's condition, if you could attach images of her face. Hoping to hear fron you soon.