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Angular Cheilitis — ORE Part 1 MCQ

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ModerateOral MedicineAngular CheilitisORE Part 1

A 70-year-old patient who wears upper and lower complete dentures has painful erythematous fissures at both oral commissures. A swab from the lesions grows Candida albicans. The dentures are poorly fitting, with reduced lower facial height. Which management is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Use topical miconazole, clean and treat the dentures, and improve denture fit

Explanation lettering: B = shown as A · C = shown as B · E = shown as C · A = shown as E

The correct answer is A. Candida-positive angular cheilitis requires topical antifungal treatment, but successful management also removes predisposing factors. In a denture wearer, the denture surface can act as a Candida reservoir, so dentures should be cleaned and treated appropriately; oral miconazole gel is licensed for oral candidosis and the SmPC advises removing prostheses at night and brushing them with gel. Poor fit and reduced lower facial height promote commissural folding and saliva pooling, so denture fit/vertical dimension should be assessed and corrected. B treats only the visible lesion; C is not required for this localised presentation and leaves the reservoir and mechanical cause untreated. D and E omit necessary antifungal treatment.

Reference: McNeil Products Ltd. Daktarin Oral Gel 20 mg/g Summary of Product Characteristics, section 4.2, updated 11 May 2026. https://www.medicines.org.uk/emc/product/14746/smpc