Synonyms: Lazy lips, corner of the mouth rashes, cheilitis angularis, angulus infectiosus (oris) or pearlècheTorn, red, scaly corners of the mouth can have a variety of causes, from local and completely harmless to severe systemic diseases. Many people are affected by corner of the mouth rashes and sometimes suffer very severely from the painful skin changes, which is why a therapy is actually always indicated, even if the actual reason for the tears is harmless.
Causes
For Mundkinkelrhagaden, there are a multiplicity of causes, that one can divide into two big groups: Local and systemic causes. The local causes of tears in the corner of the mouth include skin that is too dry or lips that are too dry, as well as corners of the mouth that are too moist, which can occur, for example, when one licks over them frequently or when there is an overproduction of saliva (hypersalivation). A strong wrinkle formation in the area of the corners of the mouth, which can be caused, for example, by the loss of a tooth, can lead to an increased accumulation of liquid here, which also promotes the development of rhagades.
Even a denture that does not fit well or against which there is even an allergy can be the cause of torn corners of the mouth. Often, rhagades of the corners of the mouth are also caused by local infections of the oral mucosa, for example an infection by Herpes Simplex viruses, certain bacteria (mostly streptococci, especially common in children) or by the fungus Candida albicans. In addition to these local infections, systemic infections, for example through treponema (syphilis) or HIV, can also lead to oral rhagades.
Other systemic causes are deficiency symptoms (such as a lack of the vitamins riboflavin or vitamin B12, zinc deficiency or iron deficiency) or an excessive intake of vitamin A (retinol). Metabolic disorders such as diabetes mellitus, Parkinson’s disease, Down’s syndrome, cirrhosis of the liver, certain autoimmune diseases such as Sjögren’s syndrome, psoriasis, neurodermatitis (or, more rarely, other eczema such as seborrhoeic eczema) can be possible causes of mouth rhagades. Allergies, especially contact allergies, for example to nickel (these become particularly clear when patients frequently put objects into their mouths that contain the allergenic substance, for example ballpoint pens with nickel), can cause corner of the mouth rhagades.
A drug exanthema can also sometimes manifest itself in the form of ripped corners of the mouth. In principle, the development of corner of the mouth rashes is always made easier if there is a weakening of the immune system (e.g. by taking certain drugs such as cortisone or certain diseases such as HIV) or if the skin has already been damaged, e.g. as part of neurodermatitis or sunburn.
In addition to the infection of torn corners of the mouth with bacteria or viruses, fungi can also enter the wound and lead to a fungal infection. This is usually caused by yeast fungi such as Candida albicans. Patients express pain while eating, drinking and also at rest.
In addition a strong unpleasant itching develops. In extreme cases, a white coating, a so-called thrush, can also develop. Thrush and leukoplakia manifest themselves as a fixed white coating on the tongue or oral mucosa.
This can come off during eating or even during the deliberate scraping and lead to bleeding. However, this occurs much more frequently in the case of a fungal infection in the area of the oral cavity. Erosions and blisters can form at the infected skin area, which eventually lead to deeper wounds.
Fungal infections often affect patients who basically suffer from immunosuppressive diseases. These include diseases such as diabetes mellitus, tumor diseases, tuberculosis, HIV, or even those that require therapy with radiation or chemotherapy. Fungal infections can also develop during treatment with antibiotics and cytostatic drugs. The infection should then be treated with an antimycotic, which is available in the pharmacy after consultation with a dermatologist, not least to avoid the formation of scar tissue.