Clinical, microbiological and ultrastructural features of angular cheilitis lesions in Southern Chinese.

Abstract

OBJECTIVE: To obtain baseline data on angular cheilitis in Southern Chinese. DESIGN: A cross-sectional investigation of the clinical, microbiological and ultrastructural features of the condition. SUBJECTS AND METHOD: Thirty six Chinese adults with angular cheilitis; 28 controls matched for age and sex, with no inflammation. Clinical examination, swabs of lesions for microbiology, impressions of lesions for ultrastructure, using replica technique. MAIN OUTCOME MEASURES: Severity of lesions, associated signs and symptoms, incidence and type of microorganisms, ultrastructural features. RESULTS: Of a total 68 lesions 32 were bilateral and four unilateral. Forty four (65%) were mild (Type I) and the remaining 24 (35%) moderate (Type II). Infective agents were isolated from 37 (54%) lesions; pure growth of Candida spp and Staph. aureus was noted in nine lesions each; a mixed growth of the two in II, beta-haemolytic streptococci in three and a mixed flora including coliforms in the other five. Candida spp were present in one control, beta-haemolytic streptococci in two and coliforms in four others. Scanning electron microscopy revealed natural topography of the angular skin with sparse colonisation by bacteria and yeasts. CONCLUSIONS: Angular cheilitis in Southern Chinese seems to be characterised by a milder clinical presentation and classic infective agents of the disease: Candida spp and Staph. aureus.