Management of Angular Cheilitis

Etiology and Assessment

• The American College of Physicians recommends considering fungal infections, primarily Candida albicans, as a common etiological factor for angular cheilitis 2, 1
• Nutritional deficiencies, particularly riboflavin and iron, are associated with angular cheilitis, according to the Clinical Nutrition guideline 3, 1

Treatment Algorithm

• The first-line treatment for angular cheilitis is combination therapy with antifungal and corticosteroid agents, addressing both fungal infection and inflammation simultaneously, as recommended by Praxis Medical Insights 1
• For primarily fungal infection, the treatment options include nystatin oral suspension, miconazole oral gel, and fluconazole, as suggested by Clinical Microbiology and Infection and Praxis Medical Insights 1, 2

Special Considerations

• Immunocompromised patients may require more aggressive and prolonged therapy, according to Clinical Microbiology and Infection and Praxis Medical Insights 2, 1
• If no improvement after 2 weeks, reevaluation for correct diagnosis and patient compliance is necessary, as recommended by Praxis Medical Insights 1