Granulomatous cheilitis and Borrelia burgdorferi: polymerase chain reaction and serologic studies in a retrospective case series of 12 patients.
BACKGROUND
Granulomatous cheilitis (GC) is a chronic granulomatous inflammation of the lips of unknown etiology, which may be associated with peripheral facial nerve paralysis and/or lingua plicata (Melkersson-Rosenthal syndrome [MRS]). Borrelia burgdorferi is a spirochete that causes Lyme borreliosis, a multisystemic infectious disease with frequent occurrence of facial nerve paralysis. An etiologic role of B burgdorferi in various granulomatous diseases has been suggested. The present study was performed to examine a possible causative role of B burgdorferi for GC/MRS by B burgdorferi-specific polymerase chain reaction analysis of biopsy specimens from affected lip tissue and determination of B burgdorferi IgG and IgM serum antibodies using enzyme-linked immunosorbent assay and immunoblot tests.


METHODS
We examined a retrospective case series of 12 patients with GC/MRS from a Lyme borreliosis endemic area (median duration of disease, 8 months [range, 3-348 months]). Borrelia burgdorferi-specific DNA could not be amplified by polymerase chain reaction in any of the 12 patients. One (13%) of 8 patients tested had a serum B burgdorferi IgG response on enzyme-linked immunosorbent assay, and 2 patients (25%) had an IgM response, but immunoblot testing yielded negative results in all 8 patients.


CONCLUSIONS
The results of the present study do not indicate that B burgdorferi has an etiologic role in GC/MRS.
Muellegger
R R
RR
Department of Dermatology, Karl-Franzens University School of Medicine, Auenbruggerplatz 8, A-8036 Graz, Austria. robert.muellegger@kfunigraz.ac.at
Weger
W
W
Zoechling
N
N
Kaddu
S
S
Soyer
H P
HP
El Shabrawi-Caelen
L
L
Kerl
H
H
D000328:Adult; D000368:Aged; D015748:Borrelia burgdorferi Group / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D004269:DNA, Bacterial / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D008297:Male; D008556:Melkersson-Rosenthal Syndrome / Q000382:microbiology* / Q000473:pathology; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies
D004269:DNA, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M