Gheilosis Successfully Treated with Synthetic Vitamin B 6

Abstract

Aykroyd and Krishnam 1 observed that the incidence of angular stomatitis (sores in the corners of the mouth, perleche, cheilosis) coincided with a deficiency of some factor or factors of the vitamin B₂ complex.

More recently Sebrell and Butler 2 produced these lesions in 10 out of 18 women subsisting on a riboflavin-deficient diet. The lesions developed in a period of 94 to 130 days. They failed to respond to nicotinic acid but responded to riboflavin, the complete healing requiring from 5 to 58 days. Sebrell and Butler 3 added more evidence to their previous findings and these have been confirmed by others. 4 , 5 , 6

In view of these facts, it seems important to report our observations on 4 consecutive cases of cheilosis occurring spontaneously in association with other deficiency syndromes in patients admitted to this hospital and treated with synthetic vitamin B₆ [2 methyl, 3 hydroxy, 4.5 di(hydroxymethyl) pyridine].∗

The first patient treated was a 7-year-old colored girl admitted to the hospital with a diagnosis of pellagra. Pellagrous lesions were present on the hands and feet. A dietary history revealed a marked deficiency of the vitamin B-complex. There were typical cheilosis lesions of the lips, characterized by maceration and fissuring at the angles. (Fig. 1a.) There was an associated severe anemia. The patient was placed on the basic diet of Smith and Ruffin which is known to be low in the B-complex and especially so in riboflavin. 7 Treatment with synthetic vitamin B₆ hydrochloride† was started with 20 mg intravenously 24 hours after admission. Within 5 hours slight but definite objective improvement could be observed in the mouth lesion.