![]() The lining of the oral cavity (oral mucosa) meets with squamous epithelium (facial skin). What causes angular cheilitis?Īngular cheilitis occurs at the angles of the mouth where two different types of skin lining meet and act as a hinge. An overhang of the upper lip resulting in deep furrows (marionette lines).Retrognathia (abnormal posterior/set-back position of the jaw).Smoking - reduces skin turgor/elasticity.Rapid weight loss - leads to reduced skin turgor/elasticity and increased skin folds.Oral retinoid medication - can cause dry lips, eg, isotretinoin, acitretin.Genetic predisposition - eg, in Down syndrome.Sensitive skin, especially atopic dermatitis.Systemic illness, particularly inflammatory bowel disease (ulcerative colitis and Crohn disease) and Sjogren syndrome.Poor nutrition - coeliac disease, iron deficiency, riboflavin deficiency, general protein deficiency, zinc deficiency, vitamin B12 and/or folate deficiency.Dentures (especially if ill-fitted and there is associated gum recession).Oral thrush - this is more likely to occur in infancy, old age, diabetics, concurrent corticosteroid use or antibiotic use, and immunocompromised patients.Those with poor health are especially susceptible. And so, in the midst of dark and silence, of aging flesh and bone, he sings a song of Hope that pulls us to life and light.Click here for more images Who gets angular cheilitis?Īngular cheilitis is common and can affect any child or adult. He, unlike too many of that day and today, knows of a blessed Hope that redeemed this mortal world. The thrush tells us good night, yet he knows the morning is yet to come. The world Hardy painted for us was so bleak that we, with him, are startled out of our earthly despairing into this ethereal Hope. The thrush gives everything to his listeners for their joy and edification, gleaning from his own simple trust to spark his song.Īnd with that image, we come back to Hardy as he considers the song of the thrush. Even in this evening of doubt and gloom, the thrush, though he is aged and wind-worn, flings his soul across the barren world, lighting a little fire in our own souls with his. Winter seems to have disappeared, and Frost is nowhere to be found once the full-hearted and joyful song of the thrush begins. His sweet, clear, honest song rises above the gloom. Here, amid natural death and uncertainty, there is a thrush. The third thing I love about Hardy’s poem is that still small voice piercing the bleak midwinter. As the 19th century comes to a close, the New Year’s gray sky serves as a burial shroud for the solace that once was, the certainty of life and truth now dead in the minds of most. He is what makes the painting chilly instead of quietly beautiful. He is the question of the age, the existential doubt creeping into every mind, including Hardy’s, leaning past what his reason can allow. Even what he took from Autumn is empty, and so he drunkenly makes his way to the wasteland. I look again with Hardy in a different direction, only to watch as Winter fades into the horizon. As Hardy leans upon the gate, gazing out onto the barren land, I can see Frost across the way with smoky breath, smiling eerily at the poet’s unease. I see most of them in my mental painting. We have four figures to look at: Frost, Winter, Century, and Hope. The second is the careful use of capitalization. And every time I read this poem, a new element is added to my mental painting. It is beautiful, but only in an artistic and haunting way. Each line of the first two stanzas evokes a sense of chilly silence, emptiness, and death. Chimneys give rise to a hint of warmth and life at dusk. I’ve seen those black, deadened trees scraping the sky, whistling with broken tunes as the winds whips across the open fields. ![]() I’ve seen it in the chilly winters of Michigan in the country, where the gray dust of ice, dirt, and salt shrouds every surface it can lay its hands on. I can paint a picture in my head of the scene Hardy describes. There are three things I love about this poem. That I could think there trembled through
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