What is the difference between angular cheilitis, impetigo, eczema and cold sores?

September 04, 2021

Skin disorders present themselves in various forms. These conditions present themselves as a result of an irritation, infection, trauma, or a sign of an underlying disorder. They can vary in shape, size, colour and can be seen in all age groups. There are certain skin conditions that appear similar to each other, but can be differentiated based on certain clinical signs. One such group of lesions constitutes angular cheilitis, impetigo, eczema and cold sores.

Angular Cheilitis

The angle of the mouth, or the commissure, is the area that is the corner of the lip. Cheilitis refers to inflammation of the lip. A skin condition called angular cheilitis occurs at the corner of the lip, which appears as a reddish dry crust. It can be itchy, irritation and painful. It can be seen on one or both corners of the lips. It occurs as a result of bacterial or fungal infection. It can also happen because of an allergic reaction to certain food items, cosmetic items or toothpastes. In older patients, in can occur as a result of ill-fitting dentures, whereas smoking and trauma are other contributory factors. In developing countries, poor immunity and deficiency of vitamins and supplements like iron are often associated with angular cheilitis. Patients with a habit of thumb sucking, drooling and mouth breathing often moisten their corner of the mouth in the process, thereby allowing microorganisms to predominate. Angular cheilitis can last from days to years. The treatment of angular cheilitis involves application of anti-fungal ointments, or drugs with antibacterial or antifungal action. Moreover, corrections should be made with respect to dentures, abnormal habits and medical conditions.

Impetigo

'Impetere' means 'attack' in Latin. Impetigo is a skin condition which is caused by an attack of certain species of bacteria. It is characterized by yellowish crustation that appear on the face and limbs. It is also called as 'school sores' as it more commonly occurs in children. Recovery from impetigo occurs in less than a month. This condition is more likely to be seen in people living in warmer climates. Apart from an underlying disease or condition (diabetes mellitus, HIV, dermatitis, etc), impetigo can occur in people with malnutrition, mosquito bites, contact sports, etc. Regular hand washing can help reduce the chance of contracting impetigo. Impetigo lesions are such that it may or may not be filled with pus. They can be contagious in nature and can be spread through constant scratching. Hence, it is often advised that the infected person keeps his nails short. Treatment of impetigo usually includes the application of antibiotics or antifungal agents in the form of ointments. A 1% hydrogen peroxide cream is also effective in lesions that are not pus-filled. If the ulcers are caused by an underlying viral infection, then antivirals are also prescribed.

Cold Sores

Cold sores or herpes labialis another skin disorder that targets the lips. Painful ulceration and blisters on the lips occur as a result of a viral infection caused by the Herpes Simplex Virus. Prolonged exposure to heat and stress are common risk factors associated with cold sores. Women are at a risk of this form of skin condition during their menstruation period. Cold sores are most often seen in patients below 20 years of age. Spread through direct contact, cold sores can be healed within 3 weeks with the right treatment. Two to three days after the patient contracts herpes, the blisters on the lips can become visible. It can also be accompanied by inflammation of the gums, palate, etc. Herpes labialis is called cold sore because it is seen in association with symptoms of cold and fever. Treatment of cold sore is nearly similar to the treatment of angular cheilitis. However, instead of antifungal agents as used in angular cheilitis, cold sores are treated through antiviral medications. Application of antiviral ointments, zinc oxide and zinc sulphate creams and anesthetic agents can help in relieving the lesion and associated pain. Antiviral drugs like acyclovir can help in quick healing.

Eczema

'Derma' refers to skin. The inflammation of skin is called dermatitis or eczema. This condition has no distinguished feature, as the associated lesion can be in the form of rashes or ulcers or blisters or sores. The condition can be present over a small part of the body or might cover the entire body. It can be present for a short period of time or in some cases can take years to heal. The severity of this condition is strictly dependent on the patient's history of allergies, exposure to irritants or underlying medical conditions. Eczema can be of different types based on the cause behind the lesion. An allergen can result in allergic dermatitis, a dry skin can be prone to atopic dermatitis, a patient of herpes has a risk of herpetiform dermatitis, a patient with a disorder associated with scalp can get seborrheic dermatitis. An untidy, unhygienic home environment is often associated with patients suffering from eczema. The dermatitis can be a reaction to the various house bacteria or mites, but further research is needed to ascertain this. Eczema can also be genetic in nature and has been found to occur in patient with or in patients who are related to patients of celiac disease. Treatment of eczema includes application of steroid-based creams and moisturizers. Immunosuppressant and antihistaminic drugs are also prescribed depending on the history behind the dermatitis. The patient is also advised to wear clothes that cause less or no sense of itchy sensations. They are asked to bath daily more than once with warm water for 5 to 10 minutes. Excess soap or foam must be avoided. Food allergens should be recognized as early as possible.

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