Persistent Infection around mouth

[kiku88]

Someone please help me, I'm going nuts here. Between 5-7 months ago I began to get a crack on the side of my lip which I tended to with vaseline etc. This did not help at all and it's slowly and progressively got worse and worse, it has caused fairly deep cracks on the side of my lip and causes constant flaking of the skin; at first I thought this might be impetigo and began applications of fucidin cream and a course of flucloxacillin this did not help at all. I then tried clotrimazole which didn't seem to help at all.

I then tried ciprofloxacillin and began applying eye drops (chloramphenicol) this did seem to help a bit but did not eliminate the problem. I went to the doctors and was very disappointed to hear she thought it was Angular Stomatitis; she gave me a course of flucloxacillin and sudocream, I started that about a week ago and it's progressively got worse and worse. I feel my lips going partly numb, and often there is a clear/yellow fluid that manages to even leak through the sudocream but I cannot see any large blisters, perhaps tiny ones The skin on part of my lip is beginning to turn slightly yellow and is very unsightly. It feels like the infection is destroying my mouth, and it couldn't have come at a worse time as I'm sitting exams just now and it's caused severe distractions. Any advice/help would be appreciated, my gratitude would be immense. Thank you for taking the time to read my post

[Bhupinder Kaur, MD]

Hello,
Another possibility for such red, flaky rashes can be seborrheic dermatitis. The other possibility is of perioral dermatitis. Perioral dermatitis is a chronic papulopustular and eczematous facial dermatitis.Treatment consists of oral antibiotics and anti-inflammatory drugs. A mild soap or soap substitute, such as Dove or Cetaphil should be used for washing. Scrubbing should be avoided.

Antibiotics like Doxycycline and tetracycline have provided good relief in severe cases and you can get it prescribed from your dermatologist if the diagnosis is confirmed to be perioral dermatitis after examination.
I hope it helps. Take care and regards.

[kiku88]

Thank you for your reply Bhupinder, I am quite sceptical about it being angular chelitis, as it has persisted for so long even with the use of vaseline and sudocrem etc. Also lately it has spread further down to my chin on the right side of my face, and also I feel the skin toughening further up on the right side of my face, this has a slight reddish colour to it. Also even with slight rubbing (as with application of topicals) it appears to leak a runny fluid, I think I actually accidently tasted a bit on the side of my lip which seemed to be quite salty, but I am unsure as I have tried dabbing a diluted solution of detol disinfectant around the area to try and stem the spread. I am not sure if it is related but the bottom of my nose and sides have become very dry lately and begin to (very slightly) crust off)
Do you have any other ideas ? I'm under a great deal of stress at the moment with exams and what not, I'm paranoid that this will be a condition I can't cure as I have already tried a few antimicrobials (see above post)

Again, Thank you very much for your time and attention, I hope you are well yourself.

[Bhupinder Kaur, MD]

Hello,
From the symptoms it sounds like cheilitis and angular cheilitis at the corners of mouth which are caused by infection. Dry out the lesions completely by patting and air drying after washing with a mild soap and use petroleum jelly to lock out moisture. It is vital that the affected areas be clean and completely dry before application of the jelly. You can also apply small amounts of athlete’s foot cream which is available over the counter. If the symptoms persist then please consult a dermatologist as oral antimicrobials may be needed.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.