PACT Spry Menu Pages
Acquired, continued
Angular Cheilitis (Perleche)
Presents as erythema, fissures, and erosions at the corners of the mouth. May cause a painful or burning sensation.
May be triggered by lip-licking, sensitivity to a compound, vitamin deficiency (riboflavin) or iron deficiency.
May be caused or worsened by candidal or staph superinfection.
Treatment: Topical yeast treatment (Nystatin), topical antibiotic agents (Mupirocin), or low-dose topical steroids.

Leukoplakia (“White Patch”) in the Oral Cavity
In children, most often the result of chronic irritation, such as cheek or tongue biting. Etiologies may also include vitamin deficiency and candidiasis.
If the lesions are unusual or persistent, or if the child has other unusual features, consider a genetic condition, including dyskeratosis congenita.
In adults, especially those who are chronic tobacco users,
Leukoplakia: A condition commonly considered precancerous in which thickened white patches of epithelium occur on the mucous membranes especially of the mouth.
leukoplakia is considered a pre-malignant lesion, but this is not the case for children.

Oral Hairy Leukoplakia
White lesions seen on any surface of the tongue (most often along the sides of the tongue) or on the buccal mucosa. The lesions are not painful and may be smooth and flat, irregular, and "hairy" or “feathery” in appearance.
Caused by the Epstein-Barr virus (EBV) and usually seen in immuno-compromised patients, especially immunocompromise from HIV.
Angular cheilitis is often worsened by candidal or staph superinfection.
Persistent or unusual leukoplakia lesions may be a sign of an underlying disorder.
Epstein-Barr Virus is a causative agent of oral hairy leukoplakia.

View the Chapter 11 Photo Gallery.