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Angular Stomatitis

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61. Candidiasis (Diagnosis)

A Hidalgo, MD; Chief Editor: Michael Stuart Bronze, MD Share Email Print Feedback Close Sections Sections Candidiasis Overview Practice Essentials Candidiasis (see the image below) is a fungal infection caused by yeasts from the genus Candida . Candida albicans is the predominant cause of the disease. Soreness and cracks at the lateral angles of the mouth (angular cheilitis) are a frequent expression of candidiasis in elderly individuals. Courtesy of Matthew C. Lambiase, DO. Signs and symptoms Chronic (...) the following: Sore and painful mouth Burning mouth or tongue Dysphagia Thick, whitish patches on the oral mucosa Physical examination reveals a diffuse erythema and white patches that appear on the surfaces of the buccal mucosa, throat, tongue, and gums. The following are the 5 types of OPC: Membranous candidiasis - One of the most common types; characterized by creamy-white, curdlike patches on the mucosal surfaces Chronic atrophic candidiasis (denture stomatitis) - Also thought to be one of the most

2014 eMedicine.com

62. Candidiasis, Mucosal (Diagnosis)

. Dermatology . 3rd ed. Philadelphia, Pa: Elsevier Saunders; 2012. Sect. 12. Media Gallery Pseudomembranous candidiasis. Erythematous candidiasis in HIV/AIDS. Denture-related stomatitis; a common form of oral candidiasis. From Scully C, Flint SF, Bagan JV, Porter SR, Moos K. Atlas of Oral and Maxillofacial Diseases. 2010. Informa, London. Angular cheilitis; a common form of oral candidiasis, typically seen in patients with denture-related stomatitis, especially those in whom the denture needs adjustment (...) can be divided into the following four subtypes: Acute pseudomembranous candidiasis (thrush): The classic multiple white-flecks on the tongue, buccal mucosa, and palate Chronic hyperplastic candidiasis: Thick white plaques on the buccal mucosa and labial commissures Acute atrophic (erythematous) candidiasis: Erythematous patches on the palate Chronic atrophic candidiasis (denture stomatitis): A form of erythematous candidiasis, resulting from poorly fitted dentures causing a burning, sore mouth

2014 eMedicine.com

63. Dermatologic Manifestations of Hematologic Disease (Diagnosis)

is believed to diminish disulfide bond formation, which consequently reduces nail-plate pliability. Changes also occur in the oral mucosa and on the tongue. Of 378 patients with iron deficiency, 14% had angular stomatitis and almost half had alterations in tongue papillae, either a change to the filiform type or atrophy. [ , ] Diffuse hair thinning is reported in female blood donors and is believed to be caused by a decrease in the iron storage pool. Changes in hair quality, primarily increased splitting

2014 eMedicine.com

64. Dermatologic Manifestations of Gastrointestinal Disease (Diagnosis)

syndrome (Patterson-Brown-Kelly syndrome) Signs of include the mucocutaneous findings of koilonychia (brittle, spoon-shaped nails; see the image below) early loss of teeth, development of cheilosis, atrophy of the tongue, and angular stomatitis, along with iron deficiency anemia and the clinical complaint of dysphagia. [ , ] The disease is rare in patients younger than 30 years, and women are affected in 80-90% of cases. Although the earlier diagnosis of iron deficiency and the ready availability

2014 eMedicine.com

67. Endemic Syphilis (Diagnosis)

. Nontender, generalized lymphadenopathy is common, painful osteoperiostitis in the long bones (eg, tibia) can occur, and angular stomatitis resembling that caused by vitamin B deficiency can be seen. The secondary stage can persist for 6-9 months. See the image below. Second-stage condylomata lata lesions. Tertiary and late stages The development of tertiary and late-stage disease usually occurs 6 months to years after inoculation. Destruction of the bone and the cartilage in the formation of gummatous

2014 eMedicine.com

68. Malnutrition (Follow-up)

edema and ridging of the toenails. Image courtesy of the Centers for Disease Control and Prevention. This infant presented with symptoms indicative of Kwashiorkor, a dietary protein deficiency. Note the angular stomatitis indicative of an accompanying Vitamin B deficiency as well. Image courtesy of the Centers for Disease Control and Prevention. of 4 Tables Contributor Information and Disclosures Author Harohalli R Shashidhar, MD Associate Professor, Department of Pediatrics, Chief, Division

2014 eMedicine Pediatrics

69. Malnutrition (Treatment)

. This infant presented with symptoms indicative of Kwashiorkor, a dietary protein deficiency. Note the angular stomatitis indicative of an accompanying Vitamin B deficiency as well. Image courtesy of the Centers for Disease Control and Prevention. of 4 Tables Contributor Information and Disclosures Author Harohalli R Shashidhar, MD Associate Professor, Department of Pediatrics, Chief, Division of Pediatric Gastroenterology and Nutrition, University of Kentucky Medical Center Harohalli R Shashidhar, MD

2014 eMedicine Pediatrics

70. Malnutrition (Overview)

protein deficiency. Note the angular stomatitis indicative of an accompanying Vitamin B deficiency as well. Image courtesy of the Centers for Disease Control and Prevention. See , a Critical Images slideshow, to help identify clues to conditions associated with malnutrition. Signs and symptoms History According to the American Society for Parenteral and Enteral Nutrition (ASPEN), malnutrition can be classified as either being illness related (secondary to another disease or injury) non-illness related (...) and anasarca (generalized edema) Oral changes: Cheilosis, angular stomatitis, and papillar atrophy Abdominal findings: Abdominal distention secondary to poor abdominal musculature and hepatomegaly secondary to fatty infiltration Skin changes: Dry, peeling skin with raw, exposed areas; hyperpigmented plaques over areas of trauma Nail changes: Fissured or ridged nails Hair changes: Thin, sparse, brittle hair that is easily pulled out and that turns a dull brown or reddish color See for more detail. Diagnosis

2014 eMedicine Pediatrics

71. Malnutrition (Diagnosis)

protein deficiency. Note the angular stomatitis indicative of an accompanying Vitamin B deficiency as well. Image courtesy of the Centers for Disease Control and Prevention. See , a Critical Images slideshow, to help identify clues to conditions associated with malnutrition. Signs and symptoms History According to the American Society for Parenteral and Enteral Nutrition (ASPEN), malnutrition can be classified as either being illness related (secondary to another disease or injury) non-illness related (...) and anasarca (generalized edema) Oral changes: Cheilosis, angular stomatitis, and papillar atrophy Abdominal findings: Abdominal distention secondary to poor abdominal musculature and hepatomegaly secondary to fatty infiltration Skin changes: Dry, peeling skin with raw, exposed areas; hyperpigmented plaques over areas of trauma Nail changes: Fissured or ridged nails Hair changes: Thin, sparse, brittle hair that is easily pulled out and that turns a dull brown or reddish color See for more detail. Diagnosis

2014 eMedicine Pediatrics

72. Protein malnutrition in South India (Full text)

. Such deficiency signs as dyschromotrichia, hepatomegaly, moon face, angular stomatitis and xerophthalmia were frequently seen. Frank cases of kwashiorkor and marasmus were observed in 1% and 1.7% respectively of children at home. These findings and others clearly show protein malnutrition to be a problem of very considerable magnitude in the poorer communities of South India. A comparison is made with the results of surveys conducted in Africa and in Central America.

1959 Bulletin of the World Health Organization PubMed abstract

73. The tongue and oesophagus in iron-deficiency anaemia and the effect of iron therapy (Full text)

showed persistent atrophy. Angular stomatitis and koilonychia were longer in disappearing. Biopsies confirmed that filiform papillae and kerato-hyalin granules are frequently absent from the epithelium of the smooth tongues of iron-deficient patients. Iron therapy is followed by the re-appearance of keratohyalin granules and keratinized filiform papillae. Two patients complained of dysphagia, which disappeared after treatment. No abnormality in the oesophageal epithelium was found in any

1961 Journal of Clinical Pathology PubMed abstract

74. Relationship between biochemical and clinical indices of B-vitamin deficiency. A study in rural school boys. (Abstract)

Relationship between biochemical and clinical indices of B-vitamin deficiency. A study in rural school boys. 1. A study amongst schoolboys in villages around Hyderabad, India, showed that almost all the boys had riboflavin deficiency, 61% had pyridoxine deficiency, and 9.4% had thiamin deficiency as judged by enzymic tests. 2. The prevalence of angular stomatitis was 41.3% and that of glossitis was 18.2%. Biochemical deficiency of riboflavin and pyridoxine was marginally higher in children (...) with angular stomatitis with or without associated glossitis, than in children without oral lesions. 3. Treatment with B-complex vitamins (containing 4 mg riboflavin and 10 mg pyridoxine) daily for 1 month produced significant reduction in the prevalence of glossitis but had no effect on angular stomatitis. The latter responded to topical application of gentian violet. 4. Small but significant changes in erythrocyte enzymes occurred over the period of 1 month even without vitamin supplements. 5. Results

1979 The British journal of nutrition Controlled trial quality: uncertain

75. Celiac Disease

to become underweight. Anemia, glossitis, angular stomatitis, and aphthous ulcers are usually seen in these patients. Manifestations of vitamin D and calcium deficiencies (eg, osteomalacia, osteopenia, osteoporosis) are common. Both men and women may have reduced fertility; women may not have menstrual periods. About 10% of patients have , an intensely pruritic papulovesicular rash that is symmetrically distributed over the extensor areas of the elbows, knees, buttocks, shoulders, and scalp. This rash

2013 Merck Manual (19th Edition)

76. Evaluation of the Elderly Patient

neuroma, cerumen, foreign body in the external canal, ototoxicity due to use of drugs (eg, aminoglycosides, aspirin , furosemide ), Paget disease, presbycusis, trauma due to noise, tumor of the cerebellopontine angle, viral infection Loss of high-frequency range Presbycusis (usually caused by age-related changes in the cochlea) Mouth Burning mouth Pernicious anemia, stomatitis Denture pain Dentures that fit poorly, oral cancer Dry mouth (xerostomia) Autoimmune disorders (eg, RA, Sjögren syndrome, SLE (...) ; pus may be expressed from Stensen duct when bacterial parotitis is present. The infecting organisms are often staphylococci. Painful, inflamed, fissured lesions at the lip commissures (angular cheilitis) may be noted in edentulous patients who do not wear dentures; these lesions are usually accompanied by a fungal infection. Temporomandibular joint This joint should be evaluated for degeneration (osteoarthrosis), a common age-related change. The joint can degenerate as teeth are lost

2013 Merck Manual (19th Edition)

77. Vitamin Deficiency, Dependency, and Toxicity - Riboflavin

: Fortified cereals Milk Other animal products Secondary riboflavin deficiency is most commonly caused by the following: Chronic Liver disorders Long-term use of barbiturates Chronic Symptoms and Signs The most common signs of riboflavin deficiency are pallor and maceration of the mucosa at the angles of the mouth (angular stomatitis) and vermilion surfaces of the lips (cheilosis), eventually replaced by superficial linear fissures. The fissures can become infected with Candida albicans , causing grayish (...) at the angles of the mouth (angular stomatitis) and surfaces of the lips (cheilosis). Suspect riboflavin deficiency in patients with characteristic symptoms and other B vitamin deficiencies; confirm it with a therapeutic trial of riboflavin supplements or measurement of urinary excretion of riboflavin. Treat with supplement of riboflavin and other water-soluble vitamins. Last full review/revision March 2018 by Larry E. Johnson, MD, PhD NOTE: This is the Professional Version. CONSUMERS: © 2018 Merck Sharp

2013 Merck Manual (19th Edition)

78. Vitamin Deficiency, Dependency, and Toxicity - Overview of Vitamins

(vitamin B 2 ) Milk, cheese, liver, meat, eggs, enriched cereal products Many aspects of carbohydrate and protein metabolism Integrity of mucous membranes Deficiency: Cheilosis, angular stomatitis, corneal vascularization (vitamin B 1 ) Whole grains, meat (especially pork and liver), enriched cereal products, nuts, legumes, potatoes Carbohydrate, fat, amino acid, glucose, and alcohol metabolism Central and peripheral nerve cell function Myocardial function Deficiency: Beriberi (peripheral neuropathy

2013 Merck Manual (19th Edition)

79. Diarrhea in Children

antibody to tissue transglutaminase) Endoscopy for duodenal biopsy Failure to thrive Repeated episodes of pneumonia or wheezing Fatty and foul-smelling stools Bloating, flatus 72-h fecal fat excretion Sweat test Genetic testing Sometimes psoriasiform rash, angular stomatitis Zinc levels with History of hard stools Fecal incontinence Abdominal x-ray *Can also cause chronic diarrhea. Evaluation History History of present illness focuses on quality, frequency, and duration of stools, as well as on any

2013 Merck Manual (19th Edition)

80. List of cutaneous conditions

) Conditions of the mucous membranes [ ] See also: Conditions of the involve the moist linings of the eyes, nose, mouth, genitals, and anus. (acatalasemia, Takahara's disease) (actinic cheilosis) (acute membranous gingivitis, acute necrotizing ulcerative gingivostomatitis, fusospirillary gingivitis, fusospirillosis, fusospirochetal gingivitis, necrotizing gingivitis, phagedenic gingivitis, trench mouth, ulcerative gingivitis, Vincent gingivitis, Vincent infection, Vincent stomatitis, Vincent's disease (...) ) ( perlèche ) (Behçet's syndrome, oculo-oral-genital syndrome) (hairy tongue, lingua villosa nigra) (granulomatous cheilitis, orofacial granulomatosis) (dental sinus) (granuloma fissuratum) (erythroplasia) (furrowed tongue, lingua plicata, plicated tongue, scrotal tongue) (benign migratory glossitis, benign migratory stomatitis, glossitis areata exfoliativa, glossitis areata migrans, lingua geographica, stomatitis areata migrans, transitory benign plaques of the tongue) (oral hairy leukoplakia

2012 Wikipedia

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