Orofacial granulomatosis (OFG) is a chronic granulomatous disorder characterized by recurrent attacks of labial swelling and/or oropharyngeal ulcers. 1 The spectrum is diverse and may comprise facial swelling, localized tags, widespread swelling, and cobble stoning of oral mucosa and even neurological features like facial palsy. Therapy of OFG is challenging and multiple approaches are employed ranging from dietary modifications (cinnamon-and benzoate-free diet) to pharmacological agents, including corticosteroids (topical, intralesional as well as systemic), thalidomide, and minocycline, often with variable results. 2 Usage of systemic agents may also have additional risk of adverse effects. Apremilast is a