Recurrent Angular Lesions in Young Adult Female

Case at a Glance

A 19-year-old female presents with a one-year history of recurrent lesions at the corner of her mouth, characterized by mild pruritus and tenderness, with spontaneous resolution within 1-2 weeks.

Patient's Story

The patient reports experiencing intermittent episodes of a rash-like lesion at the corner of her mouth for approximately 12 months. She describes the lesion as mildly itchy and tender to touch. The episodes occur sporadically and resolve spontaneously within 1-2 weeks without treatment. She denies sharing food or beverages with others and maintains good hygiene practices, cleaning her water bottle regularly every 2-3 days. Her social history includes occasional alcohol consumption (2-3 times monthly) and she denies tobacco use.

Initial Assessment

Physical examination revealed erythematous, slightly fissured lesions at the corner of the mouth consistent with the patient's description. The patient appeared well-nourished and otherwise healthy. No systemic symptoms were reported.

The Diagnostic Journey

Given the location, appearance, and recurrent nature of the lesions, the clinical presentation was highly suggestive of angular cheilitis. The patient's good hygiene practices and lack of risk factors for infectious causes suggested a multifactorial etiology possibly related to mechanical irritation, environmental factors, or minor nutritional considerations.

Final Diagnosis

Angular Cheilitis (recurrent)

Treatment Plan

Conservative management approach including: maintenance of good oral hygiene, application of protective barrier ointment to prevent moisture accumulation, avoidance of excessive lip licking or mouth stretching, and monitoring for any changes in frequency or severity of episodes.

Outcome and Follow-up

Patient was advised to monitor symptoms and return if episodes became more frequent, severe, or failed to resolve within the typical timeframe. Educational materials provided regarding angular cheilitis prevention and management strategies.