Orofacial granulomatosis

 

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Orofacial granulomatosis showing thickening of lips and tongue, fissured tongue; thickened tongue; microscopic view of chelitis/lip inflammation)


Lip swelling is the most common symptom
Lip swelling initially may only last a few hours at a time, and can be difficult to distinguish from another type of lip swelling known as angioedema. As the condition progress, swelling tends to last for days at a time, and eventually becomes permanent. Sometimes cracking and dryness of the lips occurs.


Other common symptoms
Swelling of the face and eyes also occurs. Some effected individuals have a "fissured tongue", and may sometimes develop facial paralysis. Mouth ulcers and inflammation of the gums, known as gingivitis, is sometimes seen. Other symptoms include tongue swelling or a sensation of a burning tongue.


Orofacial granulomatosis (OFG) is an inflammatory disease
Swelling and inflammation is seen in involved tissues, with clumps of many different types of white cells. While inflammation has been blamed on various infections from time to time, there is no definite proof that OFG is due to any one infectious organism. The cause of OFG is unknown.


MAJOR SYMPTOMS

  1. Bulletlip swelling

  2. Bulletinflammation of edges of mouth (angular chelitis) MINOR SYMPTOMS

  3. Bulletfacial swelling

  4. Bulletfacial paralysis

  5. Bulletswelling of gums and cheeks


MINOR SYMPTOMS

  1. Bulletburning tongue

  2. Bulletaltered taste

  3. Bulletfacial numbness/tingling

  4. Bulletspasm of eyelids (blepharospasm)

  5. Bulletwatery eyes

  6. Bulletrunny nose, migraines


Confirming the diagnosis
As there are many possible causes of lip swelling, tests are often required to prove the diagnosis, and to exclude diseases that can mimic OFG. These tests may include blood tests, taking a sample of the involved tissue ("biopsy"), or sometimes x-rays or other specialized tests.


Treatment
Sometimes swellings will resolve spontaneously without treatment, but most persist for many years. While no one treatment is always effective, a number of options are available. These include:

  1. BulletElimination diets

  2. BulletMedications that reduce inflammation

  3. BulletRadiotherapy

  4. BulletPlastic Surgery

  5. BulletInjected steroids



References

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Last reviewed 10 June 2020

Summary

Orofacial granulomatosis (OFG: also known as Melkersson-Rosenthal syndrome, Cheilitis Granulomatosis, and Schuermann's Glossitis Granulomatosa) is an uncommon inflammatory condition effecting the face and lips. People of all ages can be affected, but it is most common in the early adult years.