Angular Cheilitis Aetiology — MFDS Part 1 MCQ
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Correct answer: A — Candida albicans and/or Staphylococcus aureus
Candida albicans and Staphylococcus aureus, alone or together, are the microorganisms most commonly associated with infective angular cheilitis. Local factors such as reduced denture support or vertical dimension, persistent saliva pooling and drooling promote maceration at the oral commissures. Iron or B-vitamin deficiency, diabetes and immunosuppression may also predispose to disease or recurrence. Herpes simplex usually produces grouped vesicles followed by ulceration rather than persistent commissural fissuring. Streptococci, dermatophytes and Malassezia are not the characteristic principal organisms, while Epstein–Barr virus and cytomegalovirus are not typical causes. Predisposing factors should be identified and corrected in addition to treating any infection.
Reference: Health Education England, Mouth Care Matters: A Guide for Hospital Healthcare Professionals, section 13.2 Causes of angular cheilitis, 2019. https://mouthcarematters.hee.nhs.uk/wp-content/uploads/sites/6/2020/01/MCM-GUIDE-2019-Final.pdf