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4.09 Perleche


Presentation

The patient complains of inflammation and soreness of the skin and contiguous labial mucous membranes at the angles of the mouth. On examination, there is erythema, fissuring and maceration of the oral commisures.

What to do:

Discussion

Perleche is associated with the collection of moisture at the corners of the mouth, which encourages invasion by Candida albicans, staphlococci, streptococci and other organisms. In children, this is often caused by lip licking, drooling, thumb sucking and mouth breathing. Adults may be troubled by age-related changes in oral architecture and poorly fitting dentures. The differential diagnosis includes impetigo and herpes simplex infections. Vitamin B deficiency can be the cause, but this is rare and should not be treated presumptively.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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