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Angular Cheilitis & Nutritional Deficiency

By Ruth Coleman

Proteins, carbohydrates, the essential fatty acids, minerals and vitamins are all needed to stay healthy. A nutritional deficiency can, therefore, result in a variety of diseases and disorders. To determine which nutrient you may be deficient in, a physician will need to perform a careful exam which includes lab tests, a physical exam and nutritional history.


Riboflavin is also referred to as vitamin B2. The main sources of this vitamin are milk and dairy products, but manufacturers also use it as a food additive because it has such a deep yellow color. The cells use riboflavin to help break down carbohydrates to glucose, and provide the energy needed to carry out various processes, as described in “Harper’s Illustrated Biochemistry” by David Bender, Ph.D., Senior Lecturer in Biochemistry at the University College London. Riboflavin metabolizes fats and functions as an antioxidant, destroying the oxygen-free radicals which can damage the cells and their DNA.

Angular Cheilitis and Riboflavin Deficiency

If you have a riboflavin deficiency, then you probably have a deficiency in the other B vitamins as well, according to Larry Johnson, M.D., Ph.D., Attending Physician at the Central Arkansas Veterans Healthcare System in “The Merck Manual for Healthcare Professionals.” One of the main signs of a riboflavin deficiency, however, is angular stomatitis, also called angular cheilitis. In this condition, the corners of the mouth become soft and pale, the skin becomes irritated and fissures develop. It is common for the fissures to get infected with the Candida albicans fungus.

Angular Cheilitis and Iron Deficiency

The red blood cells use iron so they can make hemoglobin. There are an estimated 300 hemoglobin molecules on every red blood cell, and each molecule can hold four oxygen molecules. Thus, the red blood cells use hemoglobin to deliver oxygen to all the cells and tissues of the body, but they also use hemoglobin to take the carbon dioxide waste product back to the lungs so it can be exhaled. Besides angular cheilitis being a sign of riboflavin nutritional deficiency, it can also be a sign of advanced iron deficiency, as explained in “Harrison’s Principles of Internal Medicine” by John Adamson, M.D., Clinical Professor of Medicine at the University of California.

Crohn's Disease and Angular Cheilitis

James Dinulos, M.D. wrote an article in the October 2008 issue of “The New England Journal of Medicine” about a 10-year-old girl who had angular cheilitis among other skin disorders. One diagnosis that Dr. Dinulos considered, in reviewing all of her symptoms, was Crohn's disease. Crohn's disease can cause nutritional deficiencies because it is an inflammatory bowel disease which can affect both the small and the large intestines. The malabsorption caused by the inflammation can lead to deficiencies; the particular deficiency will depend upon which part of the intestines is affected.

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