Angular Chelitis or Herpes

[Mary_B]

At the end of March (of this year) my mouth began to crack right at the corner.  I don't remember it pussing or oozing...it would crack open and hurt pretty bad.  After about a month the other corner cracked open.  It would begin to heal and then crack open again.  I tried antifungal cream and that seemed to help things out, but it would not heal up all the way.  In addition to the cracking in the corners, the center of my lip felt very dry.  Once I used the anti fungal cream for a while, the corners healed up some but I noticed the cracking moving down to my lower lip.  At this point it did ooz some.  If I went in the sun, the corner would get very inflamed and red.

I went to see my family doctor and she stated that she thought I had a fever blister, at this point it had almost cleared up.  She told me to use sunscreen for my lips when outside and to use aquafor to keep my mouth nice and moist.  Ten days after I saw her I had my annual ob-gyn appt.  I explained to her, as well, what had been going on and she seemed concerned.  she ran some tests, one of which was a blood test for HSV1 and 2.  The results came back positive (1.15) for HSV2 and negative for HSV1.  I am so confused.....  I had my husband get tested and the same lab performed the test...his was negative.  My ob dr. said we could retest....I could have a false positive.  

I am confused about what is going on.

what is your advice?

[Dr_Aparna]

Hi,
Herpes infection is spread from person-to-person. You can get infected by direct contact (touching, kissing, rubbing) with the sores or blisters or by having sex (vaginal, anal, or oral), especially if not using a condom.
If you know definitely that it is not the case with you then the test results could be false, which can happen sometimes.This has to do with the test and not with you.
If this is ruled out what it could be is Vitamin B deficiency or it could be an allergic reaction.
Take a Multuvitamin tablet  daily, apply anti-funagal ointment on your lips.Once the lesions begin to heal then you should always keep the lips moist, dryness can lead to chapped lips.
Use a sunscreen on the lips to prevent allergic reactions.
ref:http://www.cha.state.md.us/edcp/factsheets/herpes.html

[Vanessa Lacuesta]

Hi

This seems like angular cheilitis. This skin condition usually affects the corners of the mouth and may persist for quite a time. The condition may be painful or itchy. Applying antifungal gel on the area may help .Angular cheilitis may be due to an infection such as fungal infection or it could be secondary to a nutritional deficiency such as Vitamin B and iron deficiencies.

Have you been assessed along this line?

[Mary_B]

When I saw my family doctor she ran a CBC as I had not had one in a while.  Everything came back fine.  Would the CBC have shown a vitamin B deficiency?  
I do recall that during most of the winter time my lips were peeling quite a bit.  They were chapped and dry.  Would that be a beginning sign of angular chelitis?  The corners did itch and were painful.  Even when I put any type of antifungal or fever blister treatment on the mouth it would burn.  Right now the corners have healed.  The center of my upper lip is very chapped and dry.  Do you think I should see a dermatologist now or should I wait to see if the corners crack again.  My family doc did not seem to think I had angular chelitis.  However, when I first noticed the problem, the photos I saw on line for angular chelitis looked exactly like what I was experiencing....until the cracking moved down the lip.  The skin in between the center of my lip and the corner ( on my right side) became inflamed, red, and painful.  This is when I noticed sun exposure made the lip hurt worse.  If not protected it would get really dry and crack and peel/flake.  Salty foods, as well as anything with acid tend to make my lips,not just the corners of my mouth hurt.    

[Vanessa Lacuesta]

Hi

There are specific tests for Vitamin deficiencies and a CBC would not show this. A hemogram showing the size and the character of the red blood cells may be able to show possible vitamin deficiencies if anemia is present. With regards to your lip condition, angular cheilitis appears to be likely here. Applying antifungal gel on the area, avoiding spicy food and hot beverages will help. Also, use a mild toothpaste. Choose a toothpaste with no fluoride as there are cases of hypersenstivity to fluoride. Avoid biting the lip or licking the lips. Observe good oral hygiene. Other differentials will be exfoliative cheilitis. But this is likely present in immunosuppressed indviduals.