Orofacial granulomatosis of the lower lip and cheek: report of a case

Orofacial Granulomatosis - A Rare Case Report with Review of Literature

“…The precise etiology is unknown but a genetic predisposition may be possible (5). A cell mediated hypersensitivity reaction is predicted as an etiologic factor because of the presence of activated helper T lymphocytes expressing interleukin-2 receptors in these lesions (6). It is also postulated that the cytokine production by lymphocytic clone could be responsible for the formation of granulomas in this condition (7).…”

Orofacial Sarcoidosis and Granulomatosis

“…Orofacial granulomatosis (OFG) is a granulomatous disease. This clinicopathological entity describes patients with oral lesions characterized by persistent and/or recurrent labial enlargement, ulcers, and a variety of other orofacial features, which on biopsy have lymphedema and noncaseating granulomas (DiAlberti et al, 1992;Mendelsohn et al, 1992;Rybicki et al, 1997;Armstrong et al, 2004;Shams et al, 2007). Oral involvement generally appears in patients with chronic multisystem sarcoidosis and seldom occurs in the acute stage.…”

“…In some cases, oral involvement is the first or only, manifestation of the disease and appears as a nontender well-circumscribed brownish red or violeceous swelling, as papules, or as submucosal nodules that can occasionally either show superficial ulceration or be symptomatic. Gingival involvement presents as red gingival enlargement (DiAlberti et al, 1992;Mendelsohn et al, 1992;Rybicki et al, 1997;Armstrong et al, 2004;Shams et al, 2007). In some cases the lesions are multifocal, including the lips, the gingiva and the hard palate.…”

“…Some OFG patients have both histopathological and immunopathological features that resemble those observed in CD patients. Some of these clinical manifestations have been found to be consistent with CD, but most have not (Shams et al, 2007). Often an extensive clinical, microscopic, and laboratory evaluation may be required to identify the source of the granulomatous inflammation (Piattelli et al, 1998).…”

“…The lips are most commonly involved and demonstrate a nontender, persistent swelling. Because of the relatively nonspecific clinical findings associated with granulomatous diseases, a microscopic diagnosis of granulomatous inflammation per se often presents a diagnostic dilemma (Shams et al, 2007).…”