A Report of Two Cases of “Giant Bartholin Gland Cysts” Successfully Treated by Excision with Review of Literature

J Clin Diagn Res. 2017 Jun; 11(6): PD11–PD13.

Published online 2017 Jun 1. doi: 10.7860/JCDR/2017/26802.10088

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Bartholin’s gland cysts are one of the common vulval masses that may start as asymptomatic cysts but if left untreated, may become large and infected requiring medical attention. We are presenting two interesting and rare cases of giant Bartholin cyst and their treatment in this case report. Two female patients of perimenopausal age presented with giant vulval cysts to the outpatient department of Obstetrics and Gynaecology. They reached a size of 10 cm and 20 cm diameter respectively, presenting with some diagnostic and later reconstruction of the labia majus. MRI pelvis provided good information regarding the size, shape and extent of the cyst, which was very useful during surgery. Both these cases were successfully treated by excision of the cyst and histopathological examination after complete excision. One of the cases presented as dumb-bell shaped swelling with large cyst superiorly and smaller cyst extending into the buttock connected by narrow neck and showed cross fluctuation. This type of dumb-bell shaped presentation of Bartholin’s cyst is rather unusual and has not been reported in the available literature

Keywords: Bartholin cyst, Female reproductive system, Labial cyst, Labial swellings

A 68-year-old, postmenopausal woman was referred to plastic surgery department from the department of obstetrics and gynaecology with complaint of swelling in the right labial region present approximately over the last two years. It was small and painless, gradually increasing in size. More rapid increase in size was observed over the last three months.

On clinical examination, there was a solitary swelling situated in the right labium majus extending from the level of pubic bones down to just above the vulval fourchette inferiorly. A swelling of size 10 x 7 x 3 cm was noted, which was a soft but tense swelling with a smooth surface with no tenderness or local warmth. It was subcutaneous, extending deep into tissue planes. Fluctuation was present. Transillumination was negative. No enlargement of regional lymph nodes. A clinical diagnosis of Bartholin gland cyst was made and planned for surgical excision.

Under spinal anaesthesia, with patient in lithotomy position and a urethral foley’s catheter in situ, an elliptical vertical incision was made and the skin flaps were reflected. The large cystic swelling was exposed and separated by blunt and sharp dissection on all sides and completely excised. There was nearly 500 ml of thick straw coloured fluid in the cyst. The resultant defect in the right vulvar region was repaired in two layers.

The excised tissue was sent for histopathological examination. Cut section of the tissue showed uniloculated cyst with a smooth inner surface which was greyish brown in colour. Microscopic examination showed the cyst lined by cuboidal to columnar epithelium and the cyst wall showed chronic inflammatory cell collections. Suggestive of infected Bartholin cyst with haemorrhage.

Postoperative period was uneventful and the patient recovered fast and was discharged on seventh postoperative day after removing the sutures. She was comfortable and doing well when she came for check up after three weeks. There was no report of recurrence over the last five years [].

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a) Preoperative; b) Peroperative; c) After excision of the cyst; d) Post-operative.

A 42-year-old woman came with chief complaint of large swelling near the introitus on the right side since one and half years which grew suddenly over the last six days to the present size. Patient gave a history of fever five days prior, which was associated with chills and rigors. She was a known diabetic since one year and was on medication. There was no history of any trauma, weight loss or loss of appetite.

On examination, there were two masses one at right labia majora (23 x 11 cm) and one just below it at the right gluteal region (6 x 6 cm). Both the swellings were cystic in consistency with cross fluctuation present between the two. Transillumination was negative and getting above the swelling was absent. Per speculum and bimanual examination were normal [].

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a) Preoperative; b) Showing dumb-bell appearance; c) Peroperative; d) Postoperative.

MRI pelvis was done and the report showed evidence of very large thick walled (6 mm) bilobed heterogenous cyst, arising from the right vulval region below the level of pubic symphysis, anterior lobe-14.2 x 10.6 x 13.5 cm; posterior lobe 7.3 x 7.6 x 8.3 cm extending postero-infero-medially upto proximal one third of right thigh [].

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a) MRI of the cyst b) MRI showing dumb-bell appearance.

Patient was taken up for surgery. A vertical elliptical incision was made around the base of the cyst 1 inch away from labia and 2 inches away from anal opening. Cyst with false capsule was dissected and separated by blunt and sharp dissection on all sides. The labial cyst was excised and found to be having dark stained thick fluid; the gluteal cyst was also isolated and separated and removed in toto. Levator muscles repaired and skin was closed with 4-0 Prolene []. The excised cyst along with its extension was sent to the department of pathology for histopathological examination.

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a) Peroperative image showing cyst separation; b) Gross specimen; c) Photomicrograph (H&E, X 40) cyst lined by squamous epitlelium with inflammatory cells in the wall; d) Postoperative.

On gross examination, larger specimen of size 23 x 11 x 9 cm weighing 1500 gm: wrinkled skin with altered blood with a wall thickness of 1.5 cm; and also a smaller specimen which was a fibrofatty mass partly covered by skin of 9 x 7 x 5 cm.

Microscopic examination showed stratified squamous epithelium with underlying cyst and cyst wall showed extensive denudation of serosa. The wall was thickened and infiltrated by predominantly acute inflammatory cells. Areas of haemorrhage and congested blood vessels were also noted [].

During the postoperative period patient was put on antibiotic coverage and suture removal was done on seventh postoperative day. Wound healed well and was discharged with satisfactory result [].

Bartholin’s glands, the female counterpart of the Cowpers glands in the male, are compound racemose glands lined by columnar epithelium. Each gland measures about 0.5 cm, with a 2 cm duct, opening into the vestibule, in the groove between hymen and labia minora at 5’O and 7’O clock position. Their function is to secrete alkaline mucous for lubrication during sexual stimulation [1].

The most common types of Bartholin gland masses are cysts or abscesses [2]. Bartholin gland cysts develop from dilatation of the duct following blockage of the duct opening. An obstructed Bartholin duct can become infected and form an abscess. Abscesses are three times more common than cysts [2,3]. Women in the reproductive age group are likely to develop Bartholin abscess. Abscesses appear most likely in women at risk for sexually transmitted infections [4]. The infection is usually polymicrobial, with bacteroides and Escherichia coli being predominant organisms [5,6].

Bartholin cysts usually do not cause any symptoms, but abscesses can present with severe pain and can cause discomfort, typically during ambulation, sitting or sexual intercourse (dyspareunia). Fever may or may not be an associated feature [7]. On examination it appears as a warm, tender, soft, fluctuant mass in lower medial labia majora and may occasionally be surrounded by erythema and oedema. Large abscesses may expand into the upper labia. Other conditions that may mimic Bartholin’s abscess include hidradenitis suppurativa, lipomas, epidermoid cysts and Skene’s duct cysts [8,9]. The key to identify a Bartholin mass is the anatomic location of the mass [10].

In addition to physical examination, high definition ultrasound and MRI is helpful in aiding a diagnosis [11-13].

The initial treatment is incision and drainage with placement of Word catheter [14]. Immediate pain relief occurs upon drainage of pus. The catheter is left inside for 4-6 weeks for epithelization. Similarly, the Jacobi ring can also be used for drainage and re-epithelization of the cysts. In a randomized study on treatment of Bartholin cysts, outcomes using Jacobi rings and word catheter were comparable, but rings have a greater patient satisfaction. In the same study, 4%-17% presented with recurrence after using catheter insitu, and often there were cases of premature dislodgment of the catheter before the tract is epithelialized [15]. For deep cysts and abscesses, this treatment is not advisable [16]. However, antibiotics are not given routinely, because more than 80% of cultures from Bartholin’s cysts and about 33% of cultures from Bartholin’s abscesses are sterile.

Another common method of treatment for Bartholin glands cysts is marsupialization where a small 1.5 cm to 3 cm incision is given over the cyst allowing drainage of the secretions [17]. But in the presence of an abscess, marsupialization should not be performed. In a randomized prospective study, out of 83 women submitted to marsupialization, the most frequent postoperative symptoms were discharge at the surgical site and labial oedema and also 24.1% presented with recurrence, 68.7% had scar formation [18].

Other methods of treating Bartholin gland cysts or absceses include silver nitrate application, CO₂ laser vaporization, and needle aspiration with or without alcohol sclerotherapy and gland excision.

In randomized prospective study comparing marsupialization and silver nitrate application in management of Bartholin cyst and abscesses, both seem to be equally effective, however, with silver nitrate, complete healing with less scar formation was observed [18].

In a study in 2012 on management of Bartholin cysts with CO₂ laser vapourization, out of 127 patients, only 86.6% cured after a single laser treatment. The mean cyst size in the study was ranging from 1. 5 cm to 5.0 cm [19]. However, management of bigger size cysts with CO₂ laser ablation has not been mentioned in literature.

In a systematic review in 2009, authors concluded that all of the available treatments were associated with lesser recurrence rates, faster healing, and few adverse events. However, best treatment approach for these bigger size cysts could not be identified according to the current literature [20].

Although giant Bartholin’s cyst is reported in several case reports, dumb-bell shaped presentation has not been reported in literature. In our cases marsupulization, CO₂ laser ablation, sclerotherapy are not feasible because of the bigger size of the cysts. So we managed the cases with excision and pelvic floor repair with subsequent good outcome in both the cases. Thus, excision of the entire Bartholin gland and duct is the definitive procedure of treatment for these cases.

Though Bartholin’s cyst abscess presents as a vulval mass, a dumb-bell shaped presentation or as a giant cyst, as in our cases are very rare. Management modality of these may be altered from that of a normal presentation according to the amount of discomfort it causes to the patient and size and extent of the mass. Though physical examination and MRI help in making a diagnosis, biopsy is confirmatory. Surgical management with complete cyst excision under antibiotic coverage is the definitive treatment.

We sincerely acknowledge the help rendered by the faculty of the radiodiagnosis, anaesthesiology and pathology department of ASRAM Medical College and Hospital for their valuable help extended during the management of these patients.

Financial or Other Competing Interests

None.

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Bartholin Gland Cyst – StatPearls

Continuing Education Activity

A Bartholin gland cyst is usually a unilateral, asymptomatic blockage of the Bartholin gland that may be incidentally discovered during a pelvic exam or imaging studies. The activity describes the evaluation and management of Bartholin gland cyst and reviews the role of the interprofessional team in improving care for patients with this condition.

Objectives:

• Describe the common causes of gland obstruction which lead to Bartholin gland cysts.

• Outline the appearance of a Bartholin gland cyst and differentiate it from Bartholin gland abscess during the physical examination.

• Identify the treatment of symptomatic Bartholin gland cysts by incision and drainage with Word catheter placement.

• Outline the importance of collaboration and clear communication among the interprofessional team members to enhance care coordination and delivery of the best possible standard of care for patients with Bartholin gland cyst.

Access free multiple choice questions on this topic.

Introduction

Bartholin glands, also known as the greater vestibular glands, are a pair of 0.5 cm glands located in the lower right and left portions at the 4 o’clock and 8 o’clock positions of the vaginal introitus. The Bartholin gland is a mucus-secreting gland, which plays a role in vaginal lubrication. Bartholin glands are generally nonpalpable when not obstructed. Cysts and abscesses are often found after the onset of puberty and a decrease in incidence after menopause.[1]

Etiology

A Bartholin gland cyst is a benign blockage of the Bartholin gland that is usually unilateral, asymptomatic, and maybe incidentally found during a pelvic exam or imaging studies. Bartholin gland obstruction may occur after trauma to the area, episiotomy, or childbirth; however, it may also occur without an identifiable cause.[2]

Epidemiology

Bartholin cysts/abscesses are predominantly found in women of child-bearing age. The incidence of Bartholin cysts is most often noted at the onset of puberty and increases with age until menopause.[3] Symptomatic Bartholin cysts and abscesses account for 2 percent of all gynecologic visits per year.[4]

Pathophysiology

Bartholin glands can form a cyst and an abscess in women of reproductive age. Both are difficult to differentiate on a physical exam. The cyst is usually 2-4 cm in diameter and may cause dyspareunia, urinary irritation, and vague pelvic pain. The cyst is usually filled with nonpurulent fluid that contains staphylococcus, streptococcus, and E.coli.

History and Physical

When examining a patient with a suspected Bartholin gland cyst/abscess, it is important to inquire about the duration of symptoms; tenderness with activities such as walking, sitting, standing, or sexual intercourse; purulent drainage; and history of previous Bartholin gland cyst/abscess, vaginal bleeding/discharge, or sexually transmitted infections. Bartholin cysts often have a protracted course as they are mainly asymptomatic. Take into consideration the patient’s age, because malignancy, while rare, may have a similar presentation.

The physical exam will often reveal asymmetry with a protrusion of one side (left or right) of the inferior aspect of the vulva. Bartholin gland abscesses, unlike Bartholin cysts, are very painful. While both are primarily unilateral, Bartholin abscesses are often tender to palpation, erythematous, indurated, and may have an area of fluctuance and/or purulent drainage.

Evaluation

Bartholin cyst abscesses do not frequently require further laboratory or radiographic studies; however, wound cultures and biopsy may be performed during incision and drainage of the abscess. If sexually transmitted infections are suspected, then a sexually transmitted infection panel (including gonorrhea, chlamydia) should be considered and appropriate treatment initiated. 

If malignancy is suspected due to an atypical presentation of the mass or if the patient is over 40 years old, then a biopsy should be considered. [5]

Treatment / Management

Asymptomatic Bartholin cysts do not require further treatment. Bartholin cysts or abscesses that are spontaneously draining may be managed conservatively with sitz baths and analgesics.

Although no modality of treatment, surgical or conservative, is superior to any other in terms of recurrence rate,[6] first-time Bartholin abscesses may be treated with incision and drainage with Word catheter placement due to ease and effectiveness of treatment.

Allergy history should be obtained before beginning the procedure as the Word catheter stem is composed of latex, and marsupialization is the procedure of choice in those with latex allergies.

Although this is not a sterile procedure, a mask with a face shield and a gown are recommended.

Incision and drainage with Word catheter are performed by first cleaning the region with povidone-iodine and anesthetizing the location where the incision will be made with 3 mL of 1% lidocaine. A small, approximately 3 mm, a vertical incision should be made with a #11 scalpel along the mucosal surface of the labia minora to avoid obvious scarring and to reduce the risk of Word catheter displacement. Purulent discharge evacuated may be sent to the lab for cultures, and biopsy may also be performed at this time. Word catheter is then inserted with the balloon tip sitting within the abscess cavity. Inflate the balloon tip with 3 to 5mL of saline water. For comfort and to reduce the chance of displacement, the external portion of the Word catheter is pushed into the vagina. Word catheters should be left in place for at least 4 weeks for appropriate drainage and tract epithelization.[7]

Incision and Drainage with Word catheter placement may be attempted a second time for recurrent Bartholin abscess with the addition of antibiotics. Antibiotics should cover staphylococcal, specifically methicillin-resistant Staphylococcus aureus, and streptococcal species as well as enteric gram-negative aerobes, including Escherichia coli. Antibiotic choices include trimethoprim-sulfamethoxazole alone, amoxicillin-clavulanate plus clindamycin, or cefixime plus clindamycin. Referral to gynecology for marsupialization may also be considered at this time.

Antibiotic therapy should be considered for those who have failed initial I&D (incision and drainage) with Word catheter placement, patients with systemic symptoms including fever, patients who have suspected sepsis, and those considered at high risk for recurrence.

Marsupialization is performed by a gynecologist in the operating room, and for this reason, incision and drainage with Word catheter placement are usually attempted first. Marsupialization is performed by creating a 2-cm incision lateral to the hymenal ring, everting the edges with forceps, and suturing the edges onto the epithelial surface with interrupted absorbable sutures.[8]

Other less common procedures include silver nitrate ablation,[9] carbon dioxide laser vaporization,[10] Jacobi ring placement [11], and Bartholin gland excision as a last resort when other modalities have failed.

Women who are pregnant and have Bartholin abscesses should be treated in the same manner as nonpregnant women, with the exception of Bartholin gland excision due to the increased risk of bleeding.

Differential Diagnosis

• Other cysts (inclusion, Gartner, Skene, sebaceous, canal of Nuck)

• Vaginal prolapse

• Vulvar angiomyofibroblastoma

• Endometriosis

• Choriocarcinoma

• Myeloid sarcoma

• Perineal leiomyoma

• Myxoid leiomyosarcoma

• Fibroma

• Angiomyxoma

• Hematoma

• Myoblastoma

• Ischiorectal abscess

• Folliculitis

• Fibroadenoma

• Lipoma

• Papillary hidradenoma

• Syringoma

• Adenocarcinoma

• Squamous cell carcinoma

Pertinent Studies and Ongoing Trials

In the WoMan-trial (world catheter and marsupialization in women with a cyst or abscess of the Bartholin gland), a randomized controlled trial in the Netherlands and England between August 2010 and May 2014, 161 women were randomly allocated to treatment by Word catheter or marsupialization to compare recurrence of a cyst or abscess within 1 year.  

Recurrence occurred in 10 women (12%) in the Word catheter group and 8 women (10%) in the marsupialization group. Within the first 24 hours after treatment, 33% used analgesics in the Word catheter group versus 74% in the marsupialization group. Time from diagnosis to treatment was 1 hour for placement of Word catheter versus 4 hours for marsupialization.

Recurrence rates were found to be comparable within the two groups; however, the marsupialization group had increased use of analgesics within the first 24 hours and increased the duration of treatment.[6]

Prognosis

The prognosis is excellent but if the cyst is just aspirated, high recurrence rates have been reported. The healing and recurrence rates are similar among fistulization, marsupialization, and silver nitrate and alcohol sclerotherapy. Needle aspiration and incision and drainage, the two simplest procedures, are not recommended because of the relatively increased recurrence rate.[12]

Complications

The treatment of Bartholin’s gland cysts by traditional surgery is characterized by some disadvantages and complications such as hemorrhage, postoperative dyspareunia, infections, the necessity for general anesthesia. Contrarily, CO2 laser surgery might be less invasive and more effective as it solves many problems of traditional surgery.[13]

Postoperative and Rehabilitation Care

Sitz baths are recommended for a few days. Early ambulation and consumption of an ample amount of water are highly recommended.

Deterrence and Patient Education

The clinician, the nurse, and the pharmacist play a pivotal role in educating patients and their families about their condition. Women should be instructed to observe for any signs of infection, such as foul-smell vaginal discharge or any abnormal bleeding. Women should be encouraged to drink an ample amount of water and ambulate early, as this will help to speed their recovery.

Enhancing Healthcare Team Outcomes

The nurse, the clinician, and the pharmacist must collaborate efficiently during the care of women with Bartholin gland pathology, in order to achieve the best possible outcome for these women and their families. Women with a Bartholin gland cyst are usually first seen by the primary care provider, nurse practitioner or internist. Because of the extensive differential, it is important to involve the gynecologist in the care of these patients.

The pharmacist has a very important role in educating patients about the available antimicrobial agents and in providing them with the required information about drug-drug interactions, in order to avoid any possibly preventable complications. The pharmacist should educate the patient on compliance and encourage them to immediately report any adverse events or any concerns. 

While the actual drainage or marsupialization is done by the gynecologist, the patient follow up and teaching are done by the nurse practitioner. The nurse practitioner should educate the patient on how to perform sitz baths and maintaining perineal hygiene. If antibiotics are prescribed. All patients need a follow up to ensure healing has occurred.

The best standard of care to women with Bartholin gland cysts or abscesses could never be achieved without the interprofessional collaboration between the nurse, the clinician, and the pharmacist. Clear and effective communication among the members of the interprofessional team is key to the successful management of women with Bartholin gland pathology. [Level V] 

Review Questions

• Access free multiple choice questions on this topic.

• Comment on this article.

Figure

Bartholin Gland Word Catheter example used in the management of Bartholin cysts in some cases. Contributed by Tammy J. Toney-Butler, AS, RN, CEN, TCRN, CPEN

Figure

Bartholin’s Gland Cyst. StatPearls Publishing Illustration

References

1.

Lee WA, Wittler M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jan 30, 2023. Bartholin Gland Cyst. [PubMed: 30335304]

2.

Pundir J, Auld BJ. A review of the management of diseases of the Bartholin’s gland. J Obstet Gynaecol. 2008 Feb;28(2):161-5. [PubMed: 18393010]

3.

Yuk JS, Kim YJ, Hur JY, Shin JH. Incidence of Bartholin duct cysts and abscesses in the Republic of Korea. Int J Gynaecol Obstet. 2013 Jul;122(1):62-4. [PubMed: 23618035]

4.

Marzano DA, Haefner HK. The bartholin gland cyst: past, present, and future. J Low Genit Tract Dis. 2004 Jul;8(3):195-204. [PubMed: 15874863]

5.

Visco AG, Del Priore G. Postmenopausal bartholin gland enlargement: a hospital-based cancer risk assessment. Obstet Gynecol. 1996 Feb;87(2):286-90. [PubMed: 8559540]

6.

Kroese JA, van der Velde M, Morssink LP, Zafarmand MH, Geomini P, van Kesteren P, Radder CM, van der Voet LF, Roovers J, Graziosi G, van Baal WM, van Bavel J, Catshoek R, Klinkert ER, Huirne J, Clark TJ, Mol B, Reesink-Peters N. Word catheter and marsupialisation in women with a cyst or abscess of the Bartholin gland (WoMan-trial): a randomised clinical trial. BJOG. 2017 Jan;124(2):243-249. [PubMed: 27640367]

7.

Reif P, Ulrich D, Bjelic-Radisic V, Häusler M, Schnedl-Lamprecht E, Tamussino K. Management of Bartholin’s cyst and abscess using the Word catheter: implementation, recurrence rates and costs. Eur J Obstet Gynecol Reprod Biol. 2015 Jul;190:81-4. [PubMed: 25963974]

8.

JACOBSON P. Vulvovaginal (Bartholin) cyst treatment by marsupialization. West J Surg Obstet Gynecol. 1950 Dec;58(12):704-8. [PubMed: 14798829]

9.

Ozdegirmenci O, Kayikcioglu F, Haberal A. Prospective Randomized Study of Marsupialization versus Silver Nitrate Application in the Management of Bartholin Gland Cysts and Abscesses. J Minim Invasive Gynecol. 2009 Mar-Apr;16(2):149-52. [PubMed: 19598336]

10.

Fambrini M, Penna C, Pieralli A, Fallani MG, Andersson KL, Lozza V, Scarselli G, Marchionni M. Carbon-dioxide laser vaporization of the Bartholin gland cyst: a retrospective analysis on 200 cases. J Minim Invasive Gynecol. 2008 May-Jun;15(3):327-31. [PubMed: 18439506]

11.

Kushnir VA, Mosquera C. Novel technique for management of Bartholin gland cysts and abscesses. J Emerg Med. 2009 May;36(4):388-90. [PubMed: 19038518]

12.

Omole F, Kelsey RC, Phillips K, Cunningham K. Bartholin Duct Cyst and Gland Abscess: Office Management. Am Fam Physician. 2019 Jun 15;99(12):760-766. [PubMed: 31194482]

13.

Frega A, Schimberni M, Ralli E, Verrone A, Manzara F, Schimberni M, Nobili F, Caserta D. Complication and recurrence rate in laser CO2 versus traditional surgery in the treatment of Bartholin’s gland cyst. Arch Gynecol Obstet. 2016 Aug;294(2):303-9. [PubMed: 26922440]

Disclosure: William Lee declares no relevant financial relationships with ineligible companies.

Disclosure: Micah Wittler declares no relevant financial relationships with ineligible companies.

Jaws in the corners of the mouth – causes, treatment, prevention

Jams

Table of contents

• How do jams appear?
• Causes of jamming in the corners of the mouth
• Symptoms of pathology
• Diagnosis of angulitis
• Treatment of jamming in the corners of the mouth
• Help in the clinic “Mama Papa Ya”
  
  

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900 21

{loadposition banner-pv}Lip sticks, or corner cheilitis – a disease accompanied by the formation of areas of inflammation in the corners of the mouth. This condition can be unilateral or bilateral. In severe cases, it causes severe pain and an aesthetic defect.

How do seizures manifest themselves?

Seizures in the corners of the mouth are the result of swelling, inflammation and cracks in the skin that occur when the skin is malnourished. As a result, skin erosions and sores may appear.

Although this disease looks like herpes, it is not contagious. The inflammation also does not spread to other parts of the body. However, unilateral bites often affect both corners of the mouth over time.

Causes of jamming in the corners of the mouth

Cheilitis occurs if the corners of the mouth are constantly moistened, and there is a violation of the local immune defense of the skin. The most common causes of corners of the mouth are a fungal or bacterial infection that causes angulitis in the presence of these risk factors:

• braces on teeth;
• improperly fitted dentures;
• habit of constantly licking lips;
• salivation;
• malocclusion;
• missing part of the teeth, eg in the elderly;
• decreased elasticity of the skin around the mouth as a result of rapid weight loss or aging;
• smoking;
• deficiency of B vitamins, zinc and/or iron in the body;
• malnutrition;
• associated atopic dermatitis and other allergic diseases.

Thumb sucking is the cause of a child’s seizure.

Angular cheilitis often develops in patients with anemia, leukemia, Down’s syndrome, weakened immune system, oncological diseases, as well as in people with diabetes mellitus. Fungi of the genus Candida – the direct cause of inflammation – multiply well with a high level of glucose in the blood. In addition, diabetes weakens the immune system, making it difficult to fight infection.

Seizures often occur in people suffering from anorexia or bulimia. They are also included in the complex of signs of the Plummer-Vinson syndrome (damage to the esophagus, iron deficiency anemia, glossitis and cheilitis). Finally, this symptom appears with hypervitaminosis A, which can develop when it is excessive in food (for example, in cod liver) or in food supplements taken.

Symptoms of pathology

In case of slight inflammation, there is peeling in the corner of the mouth and discomfort when it is opened wide. Later, swelling and redness occur at the site of the lesion, small cracks appear, and the pain intensifies.

With significantly pronounced seizures, the following are noted:

• pain during eating or talking;
• sores and crusts in the corners of the mouth;
• non-healing cracks.

Stuck at the corners of the mouth – causes and treatment – require a visit to the dentist and dermatologist. Independent attempts to cope with this pathology are rarely successful. Patients suffer for a long time not only from pain. They may have problems communicating with family members, colleagues, clients at work, because with severe angulitis, the external manifestations of the disease are pronounced and unpleasant for others.

Diagnosis of angulitis

To diagnose angular cheilitis, your doctor will perform a thorough examination of the lips and oral mucosa, looking for cracks, redness, swelling, or blistering of the skin. He will also find out the possible causes of the disease in order to choose the most effective treatment for zaed.

To diagnose similar-looking conditions, such as herpes labialis and erosive lichen planus, a specialist may take a swab from the damaged surface and send the material for analysis.

Treatment of seizures in the corners of the mouth

To determine how to treat seizures, sometimes you have to consult with specialists in various fields, including an endocrinologist, an infectious disease specialist, a gastroenterologist, a hematologist. It is better if the patient can be treated by a team of doctors in one clinic.

How to get rid of a jam forever? To do this, it is necessary to eliminate the infection and high humidity of the affected area. Usually, an antifungal ointment is prescribed for seizures, and in the presence of a secondary infection, antibacterial drugs. In some cases, a dermatologist may prescribe a cream with glucocorticoids, but self-medication with such drugs is strongly discouraged. For children, special safe ointments and other medicines are selected.

How to treat bites in the corners of the lips, if they are not caused by an infectious process? In this case, it is necessary to clarify their cause (vitamin deficiency, anemia, diabetes, and so on) and, if possible, eliminate it. The skin lesions themselves are treated with a neutral agent, for example, petroleum jelly. It is important to stop smoking and organize proper nutrition, rich in proteins and vitamins.

Many patients are looking for an effective home remedy for jam. In this case, the doctor suggests the following methods:

• rubbing the skin with fresh cucumber slices;
• treatment of the corners of the mouth with aloe juice;
• lubrication of cracks with tea tree oil, which can be purchased at the pharmacy and mixed with honey or a few drops of liquid vitamin E;
• drinking plenty of water;
• eating leafy greens, tomatoes, carrots, fruits rich in vitamins.

The anti-seizure medicine should be used for a sufficiently long time until the cracks are completely healed and signs of inflammation disappear.

Help at the Mama Papa Ya Clinic

The Mama Papa Ya family clinic network invites patients who are worried about angulitis to get a doctor’s consultation and learn how to cure seizures most quickly and effectively.

We offer:

• consultations of doctors of different profiles (dentist, dermatologist, endocrinologist and others) in one medical center;
• thorough diagnosis of the causes of the disease and their elimination;
• affordable prices for medical services;
• treatment of patients of all ages.

Make an appointment with a dermatologist by phone or using the form on our website.

Description:

Seizures – inflammation and cracks in the corners of the mouth, usually caused by a fungal infection against the background of increased skin moisture, nutritional deficiencies and reduced immunity.

Reviews

Good clinic, good doctor! Raisa Vasilievna can clearly and easily explain what the essence of the problem is. If something is wrong, she talks about everything directly, not in a veiled way, as other doctors sometimes do. I don’t regret that I went to her.

Anna

I would like to thank the staff of the clinic Mom, Dad, me. The clinic has a very friendly atmosphere, very friendly and cheerful staff and highly qualified specialists. Thank you very much! I wish prosperity to your clinic.

Anonymous user

Today I removed a mole on my face at the dermatologist Kodareva I.A. Doctor is very thorough! Correct! Thanks a lot! Administrator Borshchevskaya Julia is friendly, clearly fulfills her duties.

Belova E.M.

Today I was served in the clinic, I was satisfied with the staff, as well as the gynecologist. Everyone treats patients with respect and care. We thank them very much and continue to prosper.

Anonymous

The Mama Papa Ya clinic in Lyubertsy is very good. The team is friendly and responsive. I recommend this clinic to all my friends. Thanks to all doctors and administrators. I wish the clinic prosperity and many adequate clients.

Iratiev V.V.

Visited the clinic “Mama Papa Ya” with a child. I needed a consultation with a pediatric cardiologist. I liked the clinic. Good service doctors. We didn’t stand in line, everything was the same price.

Evgeniya

I liked the first visit. I was carefully examined, additional examinations were prescribed, and good recommendations were given. I will continue the treatment further, I liked the conditions in the clinic.

Kristina

The doctor carefully examined my husband, ordered an ECG and made a preliminary diagnosis. She made recommendations about our situation and ordered additional examinations. So far, there are no comments. Financial agreements have been met.

Marina Petrovna

I really liked the clinic. Helpful staff. Was at the appointment with the gynecologist Mikhailova E.A. Satisfied, there are more such doctors. Thank you!!!

Olga

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