Angular cheilitis (angular stomatitis)
PREDISPOSING FACTORS
Angular cheilitis is most often chronic, seen in the older, and due to infective and/or mechanical causes. It is predisposed by what are known as the ‘3Ds’ (Fig. 33.2):
Dental appliance or denture-wearing, denture-related stomatitis and disorders that predispose to candidosis:
hypovitaminoses (especially B)
malabsorption states (e.g. Crohn disease) or eating disorders
possibly zinc deficiency, but only rarely
immune defects, such as in Down syndrome, HIV infection, diabetes (Figs 33.3 and 33.4), cancer, immunosuppressed people, eating disorders and others.
Disorders where the lip anatomical relationships are changed – such as when the vertical dimension of occlusion is reduced – or where lips are enlarged, such as in orofacial granulomatosis, Crohn disease and Down syndrome.