Angular Cheilitis Unresponsive to Antibiotics and Antifungals

When angular cheilitis persists despite standard antimicrobial therapy and biopsy confirms a predominantly inflammatory etiology, a distinct therapeutic pathway applies.

Clinical scenario

Angular cheilitis that has not responded to antibiotic and antifungal treatment, with the inflammatory nature of the lesion confirmed through biopsy.

Treatment approach (partial overview)

A topical immunosuppressive agent — reserved specifically for this antimicrobial-refractory, biopsy-confirmed presentation — is the basis of the regimen. The full protocol details are available via the link below.

Clinical goal: near-complete remission of angular cheilitis lesions.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/odi.13183

Moreover, pimecrolimus, as an immunosuppressor, should be reserved only in case of an AC unresponsive to antibiotics and antifungals, in which the inflammatory nature is confirmed through biopsy, in order to avoid a paradoxical worsening of clinical signs and symptoms.

After unsuccessful infiltration with triamcinolone and cryosurgery, pimecrolimus topical cream application twice a day finally lead to an almost complete remission, after 90 days of treatment.

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