Effectiveness of small-volume, intralesional, delayed-release triamcinolone injections in orofacial granulomatosis: a pilot study.
BACKGROUND
Orofacial granulomatosis (OFG) is an idiopathic disorder characterized by chronic orofacial swellings causing significant cosmetic and functional problems. Treatment with high-volume triamcinolone injections has been shown to be effective but requires nerve block anesthesia and causes a dramatic temporary increase of lip swelling.


OBJECTIVE
We have performed a noncomparative open-label pilot study in 7 patients with OFG in order to evaluate the effectiveness of small volumes of extended-release high-concentrate triamcinolone injections in reducing lip swelling and preventing recurrences.


METHODS
Seven patients with OFG were studied. Small-volume, intralesional, high-concentrate, extended-release triamcinolone was injected on the basis of a weekly schedule. A standard cycle consisted of 2 or 3 injection sessions over 14 or 21 days, depending on the clinical response.


RESULTS
After cycle completion, all patients remained without recurrences or with cosmetically acceptable slight lip enlargement for a mean time of 19 months (range, 8-30 months). No side effects were observed, except in one patient with hypopigmentation of the skin of the upper lip.


CONCLUSIONS
Slow-volume, intralesional, high-concentrate, extended-release triamcinolone injections appear to be effective in reducing lip enlargement in patients with OFG and do not require nerve block anesthesia or cause a temporary troublesome increase of swelling. A long disease-free period is generally obtained.
Department of Odontostomatological and Maxillofacial Sciences, Section of Oral Medicine, University of Naples Federico II, Italy. mdmig@tin.it
M D
MD
Mignogna
S
S
Fedele
L
L
Lo Russo
D
D
Adamo
R A
RA
Satriano
D000328:Adult; D002613:Cheilitis / Q000209:etiology / Q000517:prevention & control; D002908:Chronic Disease; D003692:Delayed-Action Preparations; D004487:Edema / Q000209:etiology / Q000517:prevention & control*; D005148:Facial Dermatoses / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006099:Granuloma / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008047:Lip Diseases / Q000209:etiology / Q000517:prevention & control*; D010865:Pilot Projects; D012008:Recurrence; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*
D003692:Delayed-Action Preparations; D014221:Triamcinolone