Talk:Angular cheilitis

Angular cheilitis

Pictures
Wow this page needs pictures

I don't think it does yet, it describes the condition well and is quite small, so a picture isn't so urgent. Sqityl 08:01, 16 May 2006 (UTC)


 * Moved image from here to the article. Barrylb 15:44, 2 December 2007 (UTC)

Hierarchy of causes
On first reading of the 'Causes' section, I got the impression the vitamin etc deficiencies where now considered the main cause. From further reading elsewhere (unfortunately don't have an authoritative reference) I get the impression that, while nutritional deficiencies are one of the causes, it's probably a minority of cases compared to the fungus, bacterial infections, etc. So it may be useful to reword/reorder the section accordingly. In particular I think the formulation "Although [it can be fungus], studies [show it can be nutritional deficiencies]" hints too strongly at nutritional deficiencies being the main cause. —Preceding unsigned comment added by 87.187.150.34 (talk) 17:52, 10 October 2010 (UTC) UPDATE: I have tried almost everything to get rid of this painful condition. I recently spoke with my pharmacist about them and she said, "Oh, that's caused by a deficiency of Folic Acid!". I started taking this supplement, and the painful cracks in my skin were gone 1 1/2 days later. Anytime I fail to take the FA, I begin developing them again. It truly does work. — Preceding unsigned comment added by 99.89.190.11 (talk) 21:58, 12 January 2012 (UTC)

Chapped Lips?
Is this condition the same as chapped lips? Most other sites seem to treat them differently. Malamockq 19:20, 16 August 2006 (UTC)

The less severe cases I described (and others edited) are meant to be chapped lips (because the page originally re-directed here), but if there is another article then I vote this information should be transferred there then deleted off this article. Bendragonbrown47 19:59, 1 November 2006 (UTC)


 * Indeed chapped lips is general drying and possibly cracking across the lips, but generally not in the corners as with this condition. it is generally due to air conditioning and/or dry cold outside air in winter (but corners of lips may be involved if excessive lip-licking occurs and promotes a fungal infection vs just dried lips).David Ruben Talk 20:51, 1 November 2006 (UTC)

Chapped lips no longer redirects here
FYI... Since the conditions are related but not the same, the chapped lips article now describes its own condition rather than redirecting here. --Ds13 05:59, 4 November 2006 (UTC)

B-12 Deficiency
The article mentions that vitamin B-12 deficiency may cause this condition. However, all the listings of B-12 deficiency symptoms I have found on the web do not mention this condition. I would be interested in a citation for this claim. 152.5.254.24 14:35, 16 January 2007 (UTC)


 * It does occur, although personal experience is not often identified and iron deficiency tends to be more commonly picked up that B12 in such screening of affected patients. I agree though, not much evidence found to cite from on searching PubMed. I've added a citation for the relative rates of deficiencies, but as for the absolute rates (i.e. incidence of having a deficincy if present with angular cheilitis) I could find no direct source. However gives for a related condition of causing sore mouths that "330 patients with recurrent aphthae was screened for deficiencies of iron, folate and vitamin B12. In 47 patients (14.2%) such deficiencies were found" David Ruben Talk 03:44, 17 January 2007 (UTC)
 * To further elucidate, B12 deficiency often leads to a type of anemia. Anemia is basically an insufficiency of the red blood cells to carry oxygen in the body, for whatever reason. It is not just caused by iron insufficiency. So the user who said that B12 insufficiency is a possible cause of angular cheilitis is correct. He or she is just going back further down the line of causes. - 74.138.205.247 (talk) 12:00, 8 June 2008 (UTC)

Also
Drug use will cause this to happen. Mostly the stimulants: amphetamine, cocaine, crack cocaine and methamphetamine. Mabey its because these drugs suck nutriants out of the body including calcium and b-vitimins and more. —Preceding unsigned comment added by 72.174.198.110 (talk) 15:49, 25 August 2008 (UTC)

Spelling
I've just noticed that on the picture, it is referred to as "CHELITIS" but is "CHEILITIS" in the rest of the article. Can this be changed? Thanks Nelliejellynoonaa (talk) 10:45, 21 February 2009 (UTC)

Original research
I removed the following as OR:
 * Many sites advertise a cure that uses a few household ingredients in various ebooks for money. These ingredients are simply antibacterial dish soap and white unscented petroleum jelly.


 * Wash your hands well with antibacterial dish soap. Wash the affected area well with antibacterial dish soap, rubbing gently but firmly. Rinse well with warm water. Dry with fresh paper towel. Wait a little for the sores to dry out a bit more after you dry it with the paper towel. Coat the sores and surrounding area with petroleum jelly and leave on for about 2 hours. Wash off petroleum jelly with more dish soap. Repeat once more.


 * Do this before going to bed. Wear a bandaid over the sores to prevent the jelly from rubbing off. Change your pillowcases regularily.


 * The dish soap kills bacteria that may be present and dries the skin. The petroleum jelly seals out any moisture, as bacteria can't live in a dry environment.


 * I understand why this doesn't have a place in WP, but it's unfortunate, as from personal experience this is a much more effective treatment than the one mentioned, and cheap and easy too...aubrey (talk) 16:14, 2 June 2010 (UTC)

This seems out of place. CompliantDrone (talk) 05:13, 9 April 2010 (UTC)

Addendum: Jamin brook re-added above material with no comment. (See Diff) I removed it once again. - CompliantDrone (talk) 06:05, 30 April 2010 (UTC)

Link to AOL Health source broken; advice dodgy?
I noticed the advice regarding treatment with topical antibiotics and antifungals comes from this source:

http://www.aolhealth.com/conditions/angular-cheilitis

And that source no longer exists, probably since the Huffington Post merged with AOL.

The advice may be sound, but the reason I was originally clicking on the source was that I personally would never think it would be safe to apply topical medicines not intended to be taken orally on the lips, where some would be consumed, and I wanted to check if this was actually real advice.

I never write anything on Wikipedia, so I don't know how I would help, but I did see this on WebMD and it also offers the advice of topical disinfectants, but isn't as specific as the advice mentioned in this article.

Here's the WebMD article:

http://www.webmd.com/hw-popup/angular-cheilitis — Preceding unsigned comment added by 70.160.243.114 (talk) 10:19, 7 March 2013 (UTC)

Pictures
We have 3 images, and none of them particularly well show the normal presentation of this condition:


 * Elderly person with no teeth, and has the sores on both sides of the mouth. Ideally another photo would also show the associated redness under the denture (denture-related stomatitis - we could use the pic for that too)

Thank you for the pictures already uploaded, but we need a better one. Lesion ( talk ) 18:39, 13 July 2013 (UTC)
 * Yes the case in the lead is a mild one. Many do indeed present like this. A more severe case would be good aswell. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 22:34, 13 July 2013 (UTC)
 * The problem is, this is a non specific term for any inflammatory and/or infective lesion in the corner of the mouth, so appearances are going to vary. But, my point is, most commonly, this condition is (i) in elderly people, (ii) on both sides of the mouth and (iii) occurs in people who wear dentures. I used that image for the lead because the other two images show young persons with only one sided involvement. The age of the close up image now used in the lead is not clear, so I felt it was slightly better. The causes of this condition in younger people with a sore on only one side are likely different to the causes in older persons. Lesion  ( talk ) 11:30, 15 July 2013 (UTC)

Rm primary source
This had to go. It was basically being used to support content about nutritional deficiency as a cause, for which we now have a review paper as a source. I'm also going to tone down the wording that nutritional deficiencies are the main cause. The majority of sources seems to be stating that there are multiple causes...with infection and local irritation being significant too.



Remaining issues

 * Systemic diseases section could do with expansion in future, but at least all the conditions mentioned are referenced now.
 * issues about an ideal image, as described above.
 * Some MEDDATE issues. Lesion  ( talk ) 12:03, 16 July 2013 (UTC)

Image placement
Hi ... my understanding of image placement is that it is to be put "near the relevant text," unless it is a gallery. See, e.g., our policy WP:IUP. But an image was just used further away from the relevant text, upward towards the top of the relevant section, with MOS being cited. I wonder if the MOS section that requires that change might be pointed to, as I'm not sure I've seen it. Thanks.

A second point -- I believe it would be appropriate to stagger our photos left/right, rather than have them all on the right side. Thoughts?--Epeefleche (talk) 17:42, 3 April 2014 (UTC)


 * Perhaps I misread the MOS: WP:MOSIM third bullet. It doesn't matter really I guess. Lesion  18:36, 3 April 2014 (UTC)
 * Thanks. Yes, I believe the issue that bullet is trying to address is that sometimes people post the image too high -- immediately above a section break.  Thanks.--Epeefleche (talk) 18:54, 3 April 2014 (UTC)


 * It must be talking about things like this: Temporomandibular_joint_disorder. Lesion  19:19, 3 April 2014 (UTC)
 * Exactly right. That's a practice that has bedeviled the images folk for years, as it breaks the line of the header.  BTW -- on staggering photos, I believe the MOS used to suggest it in years past, but now the language appears to have been changed to simply note that it is permissible.--Epeefleche (talk) 19:23, 3 April 2014 (UTC)

Systemic section- RE: Down Syndrome
This section claims that Down Syndrome has a preponderance of angular cheilitis due to macroglossia, this is somewhat false. Individuals with Down Syndrome do not have macroglossia, they have a smaller oral cavity in relation to their tongue, simply giving the appearance of a large tongue. Source — Preceding unsigned comment added by 194.83.247.121 (talk) 17:09, 6 June 2015 (UTC)
 * Have added this clarification, thanks for pointing this out. Matthew Ferguson (talk) 19:14, 6 June 2015 (UTC)

The macroglossia article already says down syndrome causes relative macroglossia. However the down syndrome article does not make this distinction. Wondering if the latter article should have this added? Matthew Ferguson (talk) 21:26, 6 June 2015 (UTC)
 * Source says large tongue.  Doc James  (talk · contribs · email) 22:08, 6 June 2015 (UTC)
 * This review article says "Finally, the tongue can be relatively enlarged if the mandible or maxilla is small or there is muscular hypotonia. This occurs commonly in Down syndrome " Better source. Will change the Down article http://www.ncbi.nlm.nih.gov/pubmed/19713845 Doc James  (talk · contribs · email) 22:11, 6 June 2015 (UTC)

Image
This image is not of good quality and thus it is difficult to determine what it is showing. It is blurry. The prior image shows the condition better IMO. Doc James (talk · contribs · email) 09:45, 26 November 2015 (UTC)


 * I haven't managed to see this particular patient again to take another pic. Assume the condition is treated. However the image of the young and fully dentate individual with a unilateral dry, scaling lesion is not the classic and common appearance of this condition. It is far from ideal. Matthew Ferguson (talk) 10:23, 26 November 2015 (UTC)
 * This however looks mostly like wrinkles. Doc James  (talk · contribs · email) 11:56, 26 November 2015 (UTC)
 * The vast majority of persons with angular cheilitis will be elderly. To avoid putting a picture of an elderly subject is unencyclopedic. I guess I will be on the look out for a similar case and try and take a better quality image. Matthew Ferguson (talk) 17:06, 26 November 2015 (UTC)
 * I cannot tell if this person has angular cheilitis from that picture. While it occurs commonly in the elderly it is also common in younger people aswell. Doc James  (talk · contribs · email) 01:59, 27 November 2015 (UTC)
 * It's more common in elderly, read the article. I'm sorry if you find the pic hard to see but this is exactly how AC presents. Matthew Ferguson (talk) 06:37, 27 November 2015 (UTC)


 * I've updated the lead with a (less blurry) image of a similar patient. Matthew Ferguson (talk) 20:48, 18 December 2015 (UTC)
 * Thanks looks good. Doc James  (talk · contribs · email) 16:36, 2 August 2016 (UTC)

Unreferenced statement in lead: "the second most common type of lip infection"
Assume that herpes labialis would be more common than angular cheilitis, however there does not appear to be any source. Matthew Ferguson (talk) 08:59, 9 July 2016 (UTC)
 * It was added in here along with an advertising link. The link was removed but not this statement. Removed. Matthew Ferguson (talk) 09:13, 9 July 2016 (UTC)

Signs and symptoms
This "Redness, skin breakdown and crusting at the corner of the mouth" is a better description of the signs of this condition than "Inflammation of corners of mouth"

With respect to treatment we say "Treatment for angular cheilitis is typically based on the underlying causes along with the use of a barrier cream" So "eg" does not really make sense before barrier cream as that is recommended regardless of the cause. Doc James (talk · contribs · email) 15:09, 30 May 2017 (UTC)

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