Orofacial granulomatosis, an uncommon immunologically mediated disorder, includes cheilitis granulomatosa and Melkersson-Rosenthal syndrome. It is clinically characterized by recurrent or persistent swelling of the orofacial tissues with a spectrum of other orofacial features and sometimes with neurological symptoms. The pathological findings are varied but are often characterized by the presence of noncaseating granuloma. We present a new case of orofacial granulomatosis with unusual histopathological findings, namely, intralymphatic granulomas. These may be the cause of the tissue edema. We demonstrated, by immunohistochemical studies, the lymphatic nature of the vessels affected by the granulomatous process.
The quadrivalent human papillomavirus (qHPV) vaccine, the first vaccine for use in the prevention of cervical cancer and condyloma acuminatum, was approved in June 2006. In 2008, the mass media reported suspected links between the qHPV vaccine and serious adverse events; however, several studies have found that the vaccine is safe and the main adverse events are mild local reactions. Erythema multiforme (EM) is an acute self-limited cutaneous or mucocutaneous syndrome characterized by the abrupt onset of symmetric target lesions. The clinical manifestations and histological features of EM, Stevens-Johnson syndrome and toxic epidermal necrolysis show considerable overlap, and they are classically considered to represent a spectrum of skin disorders. We present a case of EM following qHPV vaccination to review the cutaneous side effects of this vaccine and the possibility of more serious side effects with the administration of booster doses.
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