A comprehensive review of current treatments for granulomatous cheilitis

Abstract

Granulomatous cheilitis (GC) is a poorly understood disease process belonging to the larger group of orofacial granulomatosis. The treatment of GC has proven exceedingly difficult. While various treatments have been applied to GC, there has been no uniform or predictably successful model demonstrated in the literature. Poor understanding of the aetiological mechanisms underpinning GC has significantly hampered the development of an effective approach to treatment. Those therapies that have shown promise principally consist of agents with anti-inflammatory activity such as corticosteroids and immunomodulatory medications. On a careful review of the literature, we have found no systematic review and assessment of current treatments. We seek to address this absence in the available literature by providing a consolidated overview of current treatment for GC.

Chéilite granulomateuse de Miescher : difficulté du diagnostic

“…De nombreux traitements ont été essayés : clofazimine [6], cyclines [11], thalidomide [12], anticorps monoclonaux dans la MC [13], corticoïdes locaux ou per-os [11]. Plusieurs auteurs ont réalisé des injections intralésionnelles de corticosteroïdes [2,5,14,15].…”

Unifocal orofacial granulomatosis in retromolar mucosa: surgical treatment with Er,Cr:YSGG laser

“…Different therapeutical approaches have been proposed for multifocal OFG, including topical, intralesional or systemic corticosteroids, clofazimine, low-dose thalidomide, topical tacrolimus, TNF-α antagonists and low-level laser therapy. The response obtained to these therapies were highly variable (7,13). …”

An Update on Granulomatous Diseases of the Oral Tissues

“…63,69 Steroid-sparing medications may be used, especially in patients who present with refractory or chronic disease. Anti-TNF-α therapy may be beneficial for short-term therapy but long-term benefits remain unclear.…”

“…Anti-TNF-α therapy may be beneficial for short-term therapy but long-term benefits remain unclear. 69,70 Spontaneous remission is rare and most patients will eventually develop recurrences. Long-term follow-up is recommended since progression to systemic disease in the form CD or possibly even sarcoidosis may occur.…”