Question:
A patient presents with painful cracks at the corners of the mouth (angular cheilitis) and a swollen, red, smooth tongue (glossitis). These mucosal changes suggest a nutritional deficiency affecting the oral mucosa. Which vitamin deficiency is most characteristically associated with angular cheilitis and glossitis?
A patient presents with painful cracks at the corners of the mouth (angular cheilitis) and a swollen, red, smooth tongue (glossitis). These mucosal changes suggest a nutritional deficiency affecting the oral mucosa. Which vitamin deficiency is most characteristically associated with angular cheilitis and glossitis?
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Vitamin B2 (Riboflavin) Deficiency "2 C's": Cheilosis (cracks/fissures at the corners of lips) and Corneal vascularization.
FAD and FMN are derived from Riboflavin ($F = 2$ ATPs in electron transport, B2).
FAD and FMN are derived from Riboflavin ($F = 2$ ATPs in electron transport, B2).
Updated On: Sep 3, 2026
- Vitamin B2
- Vitamin B3
- Vitamin B6
- Vitamin B12
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The Correct Option is A
Solution and Explanation
Concept:
A patient presents with classic mucocutaneous lesions, specifically localized to the oral cavity, including inflammation and fissuring at the labial commissures (angular cheilitis) and an inflamed, depapillated tongue (glossitis).
The clinical task requires correctly matching this highly specific combination of oral mucosal findings with the classic nutritional vitamin deficiency that produces them.
Explanation:
• Vitamin B2, chemically known as Riboflavin, is a critical water-soluble vitamin that serves as a mandatory, central component of the essential coenzymes Flavin Adenine Dinucleotide (FAD) and Flavin Mononucleotide (FMN).
• These coenzymes are absolutely indispensable for a multitude of cellular oxidation-reduction (redox) reactions, most notably within the mitochondrial electron transport chain and in the metabolism of other vitamins.
• Because epithelial cells with high turnover rates (such as the mucosal lining of the oral cavity and the lips) rely heavily on continuous, robust mitochondrial energy production, they are exceedingly sensitive to riboflavin deprivation.
• A deficiency in Vitamin B2 characteristically and classically manifests as the "oral-ocular-genital" syndrome.
• The oral manifestations are the most prominent and highly tested, specifically presenting as angular cheilitis (painful fissures and maceration at the corners of the mouth), cheilosis (dry, cracked lips), stomatitis, and a magenta-colored, smooth glossitis.
• Vitamin B3 (Niacin, Option B) deficiency causes Pellagra, classically presenting with the 3 Ds: Dermatitis (typically on sun-exposed areas like the Casal necklace), Diarrhea, and Dementia.
• Vitamin B6 (Pyridoxine, Option C) deficiency can also cause glossitis and cheilosis but is more classically associated with peripheral neuropathy and sideroblastic anemia.
• Vitamin B12 (Cobalamin, Option D) deficiency causes megaloblastic anemia and severe neurological deficits (subacute combined degeneration), though a beefy red tongue can also be seen, Riboflavin is the classic textbook answer for the isolated cheilitis/glossitis combination.
Final Answer:
The highly characteristic oral mucosal triad of angular cheilitis, cheilosis, and a smooth magenta glossitis is the classic presentation of Vitamin B2 (Riboflavin) deficiency.
A patient presents with classic mucocutaneous lesions, specifically localized to the oral cavity, including inflammation and fissuring at the labial commissures (angular cheilitis) and an inflamed, depapillated tongue (glossitis).
The clinical task requires correctly matching this highly specific combination of oral mucosal findings with the classic nutritional vitamin deficiency that produces them.
Explanation:
• Vitamin B2, chemically known as Riboflavin, is a critical water-soluble vitamin that serves as a mandatory, central component of the essential coenzymes Flavin Adenine Dinucleotide (FAD) and Flavin Mononucleotide (FMN).
• These coenzymes are absolutely indispensable for a multitude of cellular oxidation-reduction (redox) reactions, most notably within the mitochondrial electron transport chain and in the metabolism of other vitamins.
• Because epithelial cells with high turnover rates (such as the mucosal lining of the oral cavity and the lips) rely heavily on continuous, robust mitochondrial energy production, they are exceedingly sensitive to riboflavin deprivation.
• A deficiency in Vitamin B2 characteristically and classically manifests as the "oral-ocular-genital" syndrome.
• The oral manifestations are the most prominent and highly tested, specifically presenting as angular cheilitis (painful fissures and maceration at the corners of the mouth), cheilosis (dry, cracked lips), stomatitis, and a magenta-colored, smooth glossitis.
• Vitamin B3 (Niacin, Option B) deficiency causes Pellagra, classically presenting with the 3 Ds: Dermatitis (typically on sun-exposed areas like the Casal necklace), Diarrhea, and Dementia.
• Vitamin B6 (Pyridoxine, Option C) deficiency can also cause glossitis and cheilosis but is more classically associated with peripheral neuropathy and sideroblastic anemia.
• Vitamin B12 (Cobalamin, Option D) deficiency causes megaloblastic anemia and severe neurological deficits (subacute combined degeneration), though a beefy red tongue can also be seen, Riboflavin is the classic textbook answer for the isolated cheilitis/glossitis combination.
Final Answer:
The highly characteristic oral mucosal triad of angular cheilitis, cheilosis, and a smooth magenta glossitis is the classic presentation of Vitamin B2 (Riboflavin) deficiency.
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