Pathology · single question
A picture of angular cheilitis is shown. What is the most likely CAUSE?
Show answer and explanation
Correct answer: B. Fungal (Candida)
Fungal — Candida albicans (B) is the most common cause of angular cheilitis in dental patients, especially those with reduced VDO, denture wearers, immunocompromised patients, or those on prolonged antibiotics. The moist, warm corner environment with skin folds is ideal for Candida overgrowth.
• Angular cheilitis can also be caused by:
- Bacterial: Staphylococcus aureus or Streptococcus (less common)
- Mixed fungal + bacterial: most clinical cases are mixed
- Nutritional deficiencies: B vitamins, iron, zinc
• Viral (A): HSV affects lips (herpes labialis) but presents differently — vesicles → ulcers at vermilion border, NOT primarily at commissures.
• Treatment: antifungal (nystatin/miconazole) ± topical antibacterial, correct underlying cause.
• Angular cheilitis can also be caused by:
- Bacterial: Staphylococcus aureus or Streptococcus (less common)
- Mixed fungal + bacterial: most clinical cases are mixed
- Nutritional deficiencies: B vitamins, iron, zinc
• Viral (A): HSV affects lips (herpes labialis) but presents differently — vesicles → ulcers at vermilion border, NOT primarily at commissures.
• Treatment: antifungal (nystatin/miconazole) ± topical antibacterial, correct underlying cause.
- A. Bacterial angular cheilitis exists (S. aureus) but is less common than fungal etiology.
- B. Angular cheilitis is MOST COMMONLY FUNGAL in etiology, caused by Candida albicans. Predisposing factors include reduced VDO, denture wearing, nutritional deficiencies (B2, iron), immunosuppression, and diabetes.
- C. HSV causes cold sores at the vermilion border, not angular cheilitis. Angular cheilitis is primarily fungal.
- D. Trauma can create commissure fissures but is not the primary etiology of angular cheilitis as a clinical entity.