Angular cheilitis and lupus rash are distinct skin issues with noticeable differences. Angular cheilitis is an inflammatory skin condition that leads to cracked, irritated corners of the mouth. Lupus can cause rashes on various parts of the body, including the face and mouth.

People with lupus — the most common type is systemic lupus erythematosus (SLE) — sometimes experience angular cheilitis. “Has anyone developed angular cheilitis with SLE?” asked one MyLupusTeam member. “It’s almost like cold sores on both sides of the corners of your mouth, but it’s not. It’s like really dry inflammation and cracking spots on the corner of your lips.”

Keep reading to learn some key differences between a lupus rash and angular cheilitis.

1. Angular Cheilitis Isn’t an Autoimmune Condition

Lupus is an autoimmune disease, which means the body’s immune system mistakenly attacks its own tissues or organs. SLE is a systemic disease — it can affect the entire body. Both SLE and cutaneous lupus erythematosus (CLE), which affects only the skin, can cause rashes.

Angular cheilitis isn’t an autoimmune condition, and it doesn’t affect the entire body. Instead, it’s a localized inflammatory condition that leads to painful cracks or sores at the corners of the mouth. Common causes include oral yeast infections like thrush, poorly fitting dentures, dental issues, and skin conditions such as eczema.

Although angular cheilitis is not caused by lupus, it can develop as a secondary complication. In these cases, contributing factors may include:

• Immune suppression from lupus or its treatments
• Nutritional deficiencies (like low levels of B vitamins or iron)
• Dry mouth
• Medication side effects
• Repeated irritation
• Secondary fungal or bacterial infections

Health conditions that affect the immune system are risk factors for angular cheilitis. In addition to lupus, conditions like human immunodeficiency virus (HIV), Crohn’s disease, and diabetes are risk factors. The autoimmune condition Sjögren’s disease, which can also occur in people with lupus, is a particular risk factor because it causes dry mouth.

“I went to my autoimmune specialist dermatologist, and he said it was common in lupus. I also get lupus mouth sores,” a MyLupusTeam member shared.

2. Angular Cheilitis Is Diagnosed Based on Appearance

To diagnose lupus rash, a dermatologist or rheumatologist will take a medical history, examine your skin, and perform various tests, including blood tests. Using the antinuclear antibody (ANA) test, your doctor will check for signs of autoimmunity in your blood work. They may also do a biopsy, which involves taking a small sample of skin tissue and examining it under a microscope to identify skin conditions.

Angular cheilitis is mainly diagnosed by its appearance, which includes irritation, scaling, or bleeding on one or both corners of the mouth. Your doctor may do a blood test to check for deficiencies in nutrients like iron or B12. In addition, a swab of the affected skin can help determine if there’s a fungal, viral, or bacterial infection that needs treatment.

If you have risk factors like an autoimmune disease, your doctor will have a better understanding of what might be causing your symptoms. In some cases, a dentist might be involved because dental problems or wearing dentures can cause angular cheilitis.

3. Sun Exposure Worsens Lupus, Not Angular Cheilitis

Between 40 percent and 70 percent of people with lupus are photosensitive, meaning their skin reacts to sunlight. As a result, lupus rashes — like the malar rash (butterfly rash) — can appear or worsen after exposure.

Sunlight can also trigger discoid lupus erythematosus, a type of CLE that causes round, disc-shaped lesions on sun-exposed areas like the face, ears, or scalp. In people with darker skin, these lesions may appear as darker patches.

Subacute lupus erythematosus, another type of CLE, can cause circular, sometimes scaly markings on the arms, chest, and back after sun exposure.

Unlike lupus rashes, angular cheilitis isn’t triggered by sun exposure. Instead, this condition usually occurs when saliva pools in the corners of the mouth and leads to dry skin that can crack and become infected.

4. Treating Lupus Rashes May Require Treating the Autoimmune Disease

Treating lupus rashes is often more complex than treating angular cheilitis. A lupus treatment plan may include therapies that target specific skin symptoms, along with medications that help control the underlying autoimmune disease.

otential treatments include:

• Topical, oral, or injected steroids
• Nonsteroidal topical treatments
• Antimalarial drugs
• Immunosuppressive drugs
• Biologics

Antimalarials, immunosuppressants, biologics, and oral steroids can help regulate immune system activity. These medications are used to treat systemic lupus and can also improve skin symptoms, including lupus-related rashes.

The right treatment for angular cheilitis depends on the cause. Antifungal, antibacterial, or antiviral creams can clear up specific infections such as Candida, Staphylococcus aureus, or herpes simplex. If a vitamin deficiency is causing your cracked lips and skin around the mouth, supplements may help. As with lupus rash, steroid creams may provide quick relief for inflamed skin.

Having lupus or another health condition may affect how quickly your angular cheilitis heals. “My dentist says angular cheilitis takes a long time to heal if on immunosuppressants coupled with the mechanical use of opening and closing your mouth,” one MyLupusTeam member shared.

Your doctor can help you find the right treatment plan to help your skin heal effectively and comfortably.

Talk With Others Who Understand

On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

Do you get oral ulcers, crusted lips, and dryness, or other oral manifestations of lupus? Let others know in the comments below.