Redness and scale at the corners of the mouth is characteristic. A fissure may form.

PERLECHE or ANGULAR CHEILITIS

The term perleche (aka angular cheilitis) refers to a common type of inflammation at the corners of the mouth. The condition begins as an intertrigo (inflamed skin secondary to irritation by chronic moisture--in this case from saliva), but may become secondarily infected by Candida and/or Staphylococcus.

• The term perleche comes from the French word, “lecher,” meaning to lick.
• Drooling at night is common.
• In children, thumb suckers, gum chewers and lollipop eaters are typical.
• Teens or young adults may wear retainers, increasing saliva production.
• Older individuals may wear dentures, have poor dentition or just have decreased vertical dimensions about the mouth causing a prominent fold (drawing saliva via capillary action).
  
• Very rarely, drugs (e.g. isotretinoin), allergic contact dermatitis (e.g to toothpaste), infections (e.g syphilis), systemic conditions (e.g. atopic dermatitis) or nutritional deficiencies (e.g. iron deficiency) are associated.

Treatment, Brief Overview

• If any of the above associations/triggers are identified, treat them.
• Desonide oitment BID
• Vaseline at other times and for maintenence.
• If not much better/clear in 7 days, adding in clotrimazole or nystatin (for fungus) or bacitracin (for Staphylococcus) may be indicated. If still not better, further workup may be indicated.

RegionalDerm

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