Cheilitis Granulomatosa: A Review

Abstract

Cheilitis granulomatosa (CG) is a cosmetically disturbing and persistent idiopathic lip swelling. It is one manifestation of orofacial granulomatosis (OFG), which is a clinical entity describing facial and oral swelling in the setting of non-caseating granulomatous inflammation and in the absence of systemic disease such as Crohn's disease and sarcoidosis. CG can occur by itself or as part of the Melkersson-Rosenthal syndrome, which includes facial palsy and a plicated tongue. Other proposed causes of OFG include dietary allergens such as cinnamon and benzoates. Similar orofacial swelling may be an early manifestation of Crohn's disease or sarcoidosis, and so clinical history is important in diagnosis. The cause of CG has not been wholly elucidated, but a current hypothesis holds that a random influx of inflammatory cells is responsible. Other granulomatous and edematous causes of lip swelling must be investigated prior to diagnosis. Options for treatment include dietary modifications, antibiotics, systemic or intralesional corticosteroids, and surgery, although treatment is not always necessary. CG should be considered in the differential of persistent lip swelling.

Lip leishmaniasis: a case series with molecular identification and literature review

“…Accordingly, clinical diagnosis of lip leishmaniasis is frequently a challenge with a significantly delayed diagnosis or even an erroneous clinical diagnosis of malignancy [12, 19, 25]. The most important diseases that must be taken into account in differential diagnosis are herpes labialis [26], syphilitic chancre [27], Melkersson-Rosenthal syndrome [28], orofacial granulomatosis [28], cheilitis granulomatosa [29, 30], Wegener granulomatosis [12, 19, 25], oral Crohn’s disease [31], sarcoidosis [32, 33], skin tuberculosis [34], discoid lupus erythematosus [34], lymphoma [34], foreign body giant cell granuloma [12, 19, 25, 28], leprosy [35], mycotic infection [36], fibroma, lipoma, and neuroma [37], basal cell carcinoma [38], and squamous cell carcinoma [34, 39]. The diagnosis is easier to make if typical CL lesions are present elsewhere on the skin.…”

Angioedema Masqueraders

“…11 In many cases, the upper lip seems to be the first site of involvement, followed by the lower lip. 11 In many cases, the upper lip seems to be the first site of involvement, followed by the lower lip.…”

Orofacial granulomatosis: do not forget leishmaniasis

“…Other causes of granulomatous diseases must be investigated in order to find uncommon aetiologies 1 2. Mucocutanous leishmaniasis most commonly affects the upper respiratory tract.…”