Science Based Angular Cheilitis Treatment
Cheilitis is inflammation affecting the lips. Angular cheilitis usually begins as redness and peeling of the skin at the angles (corners) of the mouth. As the condition continues, cracks occur in the skin and mucous membranes at the commissure (corners) of the lips. This condition is usually caused by infection with Candida albicans. Other factors may also contribute to the lesions. These include vitamin B complex deficiency and decreased vertical dimension associated with inadequate dentures. Angular cheilitis is also a frequent finding in patients who have been infected with the human immunodeficiency virus (HIV).
The answer is c. (Murray, pp 627-661. Scriver, pp 3897-3964. Sack, pp 121-138. Wilson, pp 287-320.) Pernicious anemia results from an inability to absorb vitamin B12 from the gastrointestinal tract. This may be due to a deficiency of intrinsic factor, surgical gastrectomy, or small bowel disease. The earliest clinical signs of pernicious anemia do not appear until 3 to 5 years following the onset of vitamin B12 deficiency. The term pernicious indicates a potential fatal outcome. Cheilosis is dryness and scaling of the lips that is characteristic of riboflavin (vitamin B2) deficiency. Scurvy is caused by vitamin C deficiency and is characterized by bleeding gums and bone disease. Rickets is softening and deformation of the bones due to vitamin D deficiency or defects in vitamin D processing. The word beriberi is Singhalese for I cannot, referring to muscular atrophy and paralysis memory, lackadaisical behavior, and a continuous rhythmic movement of the eyeballs. Thiamine dietary...
This rare dermatosis occurs most frequently on the genital skin and lower abdomen. The distinctive eruption consists of an erythema with erosions, vesiculation, and bulla formation. The rash extends outward with healing and crusting at the outer edge. Postinflammatory pigmentation is common. There is also an associated weight loss, glossitis, and angular cheilitis. The patient may also have diabetes. Histologi-cally, there is marked epidermal necrolysis and a mild dermal lymphocytic infiltrate. It is nearly always associated with an underlying pancreatic glucagonoma. The dermatosis resolves with treatment of the glucagonoma and correction of nutritional deficiencies secondary to malabsorption (Table 15).
Are one of the cardinal signs of kwashiorkor. Protein energy malnutrition or even more milder forms of nutritional depletion can be correlated with decreased gastrointestinal mucosal integrity as measured by the lactulose mannitol ratio.125 Also, vitamin A deficiency has been found to have a similar effect on gut integrity by the same test.126 Striking histological changes are noted in the epithelia of vitamin A-deprived animals characterized as metaplastic hyperkeratosis that are rapidly reversible upon vitamin A repletion.127,128 Although severe zinc deficiency results in characteristic skin lesions,129 mild to moderate zinc deficiencies also compromise the integrity of the gastrointestinal and respiratory epithelia.130,131 Indeed, specific nutrient deficiencies are often manifest by epithelial lesions Dermatosis and mucosal atrophy are noted in pellagra dermatosis and dermatitis, cheilosis, and angular stomatitis are manifest in pyridoxine deficiency and subcutaneous atrophy and...
Infection in the mouth, thrush, is manifested by redness and whitish mucosal plaques (Fig. 3.1). Lesions can be diffuse or affect a single region like the palate, the buccal mucosa, gums, or tongue (glossitis). Plaques are asymptomatic or accompanied by a burning sensation. The following forms have been described erosive, hyperplastic, pseudomembranous, erythematous (atrophic), acute or chronic, as well as forms with plaques and nodules. Lip involvement is exceptional, but frequently in the corners of the mouth, angular cheilitis, a triangular area of fissures and erythema, is seen. Black-hairy tongue may be due to Candida or Geotrichum strains. Esoph-ageal involvement occurs mainly in patients with AIDS and in leukemic patients.
Although often not clinically apparent, the primary lesions of endemic syphilis are nonetheless an important source of infection to others. The initial lesions, resulting from either direct or indirect inoculation, are painless mucous patches occurring on oral mucosal surfaces. The mucous patches of endemic syphilis are pale or white shallow ulcerations that may occur anywhere within the mouth. These lesions in turn may give rise to secondary lesions that may present as angular stomatitis (split papules) or more widely disseminated papular cutaneous lesions similar to those seen in yaws. Also similar to yaws, patients with endemic syphilis may experience a wide variety of secondary cutaneous lesions (papillomas, macules, and rashes of all types and locations) as well as periostitis, which may cause permanent bony deformity Patients with late stages of endemic syphilis may also experience destruction of nasopharyngeal cartilage, causing gangosa.
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