DERMATOLOGY COMMUNITY
refractory angular cheilitis

refractory angular cheilitis

I've had angular chelitis for years now. I never knew it was even a "medical condition" until I went to have a teeth cleaning in June and the dentist told me what it was. He prescribed nystatin and triamcinolone ointment to apply 4x a day. It cleared up immediately but I still continued using the ointment for about two weeks afterward (just in case...) before I stopped. But I eventually did stop and the cuts came back within two or three days. So next time I went to see my primary care provider I mentioned this, and she put me on 100mg fluconazole po for 14 days, suggested I continue using the ointment during that time, but that after the 14 days I should be able to stop using both. The cuts at the corners of my mouth came back again 2 days after I stopped treatment. Since it was suggested to me by my PCP, I ditched all old lipstick and chap stick and have been using vaseline on my lips... but it still hasn't helped.

Is it reasonable to expect I will have to use this nystatin/triamcinolone every day for the rest of my life if I want to stay free of these cuts? Or is there another option? I am hesitant to bother my PCP again with this since she acted like oral anti-fungals were the last option, but these cuts are stupid, painful (especially when you get them "new" again after they've healed), and annoying. I'm also wondering why someone healthy (27 years old, no significant medical history) is having recurrent fungal infections?
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