Thanks I am grateful for your help.Also I would like to share the various
other responses which have come to me from outside the Evidence base
network.
Angular stomatitits and cheilitis have these etiologies and causes as
differential diagnosis-
Recurrent Herpes simplex infection (5-15 episodes per year)
Candidiasis and other fungal infections
Vit B1 deficiency (Not corrected by oral - as first manifestatin of
malabsorption syndrome or as the only manifestation. Give a therapeutic
trial of Injectable Vit B.)
Bechet's, Pemphigus (Both can be proved by lip biopsy)
Dr. Anurag Bharadwaj
Associate Professor of Medicine
Melaka- Manipal Medical College
Jalan Batu Hampar, Bukit Baru, 75150 Melaka
Tel: 60-6-2925851 Ext.1041(Off)1076(Res)
Fax: 60-6-2925852
Email: [log in to unmask]
Malaysia
Dear Rakesh,
Thank you for the data.I would consider Inflammatory Bowel Disease.I have
seen pts of IBD present with persistent Apthous Ulcers.Also investigate for
Syphilis and HIV.Best wishes.
Dear Rakesh,
What about a fungal infection? I had someone very like this recently who
responded beautifully to clotrimazole cream.
Let me know what you think.
Janette
Dear Rakesh,
Have you done a VDRL?
Regards,
Rout
Thanks everybody,
I shall consider a therapeutic trial of antifungal cream after taking a
scraping for fungal hyphae and a blood for VDRL although it will need a
forbidding pre test counselling .After assessing response to this initial
treatment, if in the negative i may go ahead with a lip biopsy.
Rakesh Biswas MD, Asstt Prof, Dept of Medicine,
Manipal Teaching Hospital, Pokhara
Pin-33701, Nepal, phone 009776126416-20-extn 189,Fax-00977-61-27862
[log in to unmask], [log in to unmask]
----- Original Message -----
From: anne nichols <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, April 19, 2002 6:56 PM
Subject: Re: Persistant angular cheilitis
> Dear Sir:
> Have you considered lip licking as a possible cause?
> Below are some articles that may be of help.
>
> 1.Epidemiology of eczematous cheilitis at a tertiary dermatological
referral centre in Singapore.
> Contact Dermatitis. 2000 Dec;43(6):322-6.
> PMID: 11140381 [PubMed - indexed for MEDLINE]
>
> 2.Senile lip licking.
> Dermatology. 1995;191(4):339-40. Review. No abstract available.
> PMID: 8573936 [PubMed - indexed for MEDLINE]
>
> 3. Factitious lip crusting.
> Arch Dermatol. 1981 Jun;117(6):338-40.
> PMID: 6972736 [PubMed - indexed for MEDLINE]
>
> Anne Nichols, CRNP
> Nurse Practitioner
> Widener University
> Chester,PA
>
>
>
>
> >From: Rakesh Biswas <[log in to unmask]>
> >Reply-To: Rakesh Biswas <[log in to unmask]>
> >To: [log in to unmask]
> >Subject: Persistant angular cheilitis
> >Date: Fri, 19 Apr 2002 07:21:46 +0530
> >
> > A middle aged white lady has persistant angular cheilitis and
stomatitis since the last 4 months(fig 1). She is a yoga teacher on a
vegetarian diet and has taken all possible vitamins and essential nutrients
available along with various antibiotic creams(partly self medicaton). What
are the possible causes and what further line of management would benefit
the patient? Rakesh Biswas MD, Pokhara, Nepal
> ><< angularcheilitislowkb.jpg >>
>
>
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