DefinitionThis section has been translated automatically.
Polyätiological, acute or chronic, mostly rhagadiform inflammation of the corners of the mouth. Often with mycotic or bacterial infection at the base of an anatomical malposition.
EtiopathogenesisThis section has been translated automatically.
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Clinical featuresThis section has been translated automatically.
First described redness and scaling in the corner of the mouth, then rhagade formation. Formation of an oval, lenticular to pea-sized, erosive-crusty plaque. Particularly in older people the finding can be completely covered by the overhanging lips and only becomes visible when the lip sections are pulled apart.
DiagnosisThis section has been translated automatically.
- Clinical picture with painful rhagades
- Eminently chronic course
- Therapy resistance (if cause is not eliminated)
- Often age-related lip atrophy
- Smear with examination for fungi and bacteria (not infrequently detection of yeasts (Candida species))
- Syphilisserology(Plaques muqueuses = rare cause)
- Exclusion of a diabetic metabolic condition
- Exclusion of anaemia/iron deficiency
- exclusion of avitaminosis (vitamin B12 deficiency), zinc deficiency
- Clarification of an atopic diathesis
TherapyThis section has been translated automatically.
Treatment of the underlying disease e.g.:
- Lip involution: In case of senile lip involution with overlapping wrinkles in the area of the corners of the mouth and age-related turgor loss of the facial skin, consistent lip care with regular cleaning of the corners of the mouth (e.g. with dexpanthenol ointment).
- Candidosis of the oral mucosa: consistent antimycotic therapy. S.u. Antimycotics.
- Bacterial colonisation: Apply antibiotic-containing ointments, e.g. Fucidine ointment, several times a day to the corners of the mouth. Alternatively: application of disinfectant ointments or emulsions such as 0.5% Clioquinol-Externa(e.g. Linola-Sept, R049 ). In the case of a highly inflammatory overlay, the use of combination preparations ( glucocorticoid and antibiotic or antifungal) can be helpful in the short term (e.g. Decoderm tri cream, Candio-Hermal Plus paste, Lotricomb cream). Limit glucocorticoid combination preparations to 10 days' use.
- For atopic cheilitis, use consistent lip care.
TablesThis section has been translated automatically.
Causes of perlèche
Candida species (so-called angulus infectiosus candidamyceticus, see also candidosis of the oral mucosa)
Streptococci, staphylococci (e.g. in impetigo contagiosa), often mixed flora
In case of unilateral perlèche V.a. syphilis (see below Syphilis acquisita)
Unhindered salivation in the absence of oral closure (elderly) or in age-related dermatochalasis with the upper and lower lateral parts of the lips lying on top of each other.
Hypersalivation (e.g. in mongolism)
In the context of lip eczema
As a manifestation of atopic eczema
Vitamin B12 deficiency (pernicious anemia)
Incoming links (18)Angular cheilitis; Angulus infectiosus candidomyceticus; Angulus infectiosus oris; Ariboflavinosis; Atopy; Atopy; Cheilosis; Chronic mucocutaneous candidiasis; Corner of the mouthcheilitis; Corner of the mouth rhagades; ... Show all
Outgoing links (12)Antibiotics; Antimycotics; Atopic diathesis; Avitaminosis; Candidoses; Cheilitis atopic; Clioquinol; Clioquinol cream 0.5-2% (o/w); Glucocorticosteroids; Plaques muqueuses; ... Show all
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