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ABSTRACT Angular chelitis is inflammation typically seen at the both commissures (angles) of the lips. An- gular chelitis is most often chronic seen in the older and due to infective and/or mechanical causes. It is diagnosed clinically and treated with topical antifungals and antibacterial. The goals of this case report and literature review is to describe angular cheilitis (soft-tissue disorders) in the oral cavity that is commonly observed in diabetes and to discuss the clinical presentation associated causative factors and management strategies of angular chelitis.
Key Word: Angular Chelitis fungal infections Vit B complex deficiencies.
INTRODUCTION Angular cheilitis is inflammation of one or more commonly both of the corners of the mouth. Initial- ly the corners of the mouth develope a gray-white thickening and adjacent erythema (redness). Later the usual appearance is a roughly triangular area of erythema edema (swelling) and maceration at either corner of the mouth. Typically the lesions give symp- toms of soreness pain pruritus (itching) or burning or a raw feeling in the later stage. Angular cheilitis often represents an opportunistic infection of fungi and/or bacteria with multiple local and systemic predisposing factors involved in the initiation and persistence of the lesion. Such factors include nutritional deficiencies over closure of the mouth4 dry mouth a lip-licking habit4 drooling 4 and immunosuppression.5 Treatment for angular cheilitis is based on the exact causes of the condition in each case but often an antifungal cream is used among other measures.
CASE REPORTS CASE 1 In July 2014 a 52 years old male attended Oral Diagnosis and Medicine Department of Sir Syed Dental Hospital. His chief complaint was pain in upper right side of teeth particularly in third molar since 25 days. Pain was severe and intermittent in nature radiated towards head aggravated on eating food and relieved by analgesic. During intra oral examination upper right third molar was found grossly carious. Working diagnosis was reversible pulpitis and an OPG x-ray was taken. He was advised to have extraction of this tooth because it was grossly carious. During further facial and oral examination angular cheilitis was detected but the patient was not aware of it. He had a history of diabetes mellitus type 2 and high blood pressure since 15 years. The patient stated...