Melkersson-Rosenthal syndrome

Orofacial granulomatosis: presentation, pathology and management of 13 cases

“…Lip enlargement may be unilateral or favor one side at first, but gradually become more symmetrical in nature (16, 17, 25). Eyelid and lip swelling presents as a soft, non‐tender, non‐pitting process of sudden onset, which may resemble angioneurotic edema (13, 14, 16). However, with repeated episodes, there is a progressive permanent enlargement of the lip, secondary to continuing fibrosis (15).…”

“…The prevalence of facial palsy associated with orofacial granulomatosis varies in different reports (1, 14, 17). The facial paralysis probably results from direct granulomatous infiltration of the facial nerve or its sheath, or may be secondary to the nerve compression by edema within the bony canal of the temporal bone (1, 13). It is characteristically sudden in onset and may be indistinguishable from Bell's palsy (32).…”

“…More than a decade later, Miescher (6) independently described repeated, chronic, localized, episodic lip enlargement caused by non‐caseating granulomatous infiltration and obstruction of lymphatic drainage, but without facial paralysis, adopting the terminology ‘cheilitis granulomatosa’, also known as ‘Miescher's cheilitis'. Since then, numerous case reports of MRS and cheilitis granulomatosa (3, 12–28) have been described.…”

Lip impressions: a new method for monitoring morphological changes in orofacial granulomatosis

“…This feature is in accordance with the characteristics of swelling of the lips reported in the literature. In OFG the labial oedema is often unilateral at the beginning, but gradually becomes more symmetrical in nature (Nally, 1970; Vistnes and Kernahan, 1971; Alexander and James, 1972). All our patients presented to the Oral Medicine Clinic at least 2 years after the onset of the disease.…”

“…Although the swelling may be transient with complete resolution initially, repeated episodes of granulomatous inflammation may eventually lead to the formation of a firm indurated lip, secondary to fibrosis (Alexander and James, 1972). At the beginning, the lip enlargement can be unilateral, but it gradually becomes more symmetrical in nature (Nally, 1970; Vistnes and Kernahan, 1971; Alexander and James, 1972). Patients may present with swelling affecting only the upper or lower lip, but involvement of both lips is not uncommon.…”