Cheilitis granulomatosa associated with Melkersson-Rosenthal syndrome.
Melkersson-Rosenthal syndrome (MRS) consists of persistent or recurrent orofacial edema, relapsing facial palsy and fissured tongue. The complete triad of symptoms is uncommon, varying from 8 to 25%. The presentation of only one symptom is more common. The most frequent complaint is facial edema and enlargement of the lips. We describe a case of a 17-year-old Brazilian girl with limited edema of the lower lip and fissured tongue due to MRS. Her complaints had started two years before. She referred previous clinical treatments without success. We proposed intralesional injection of triamcinolone at 20 mg every 15 days associated with oral clofazimine at 50 mg/day for three months. The lip became normal after four triamcinolone injections. Recent studies have considered MRS a granulomatous disease, and possibly the initial presentation of Crohn's disease in orofacial area of some patients. MRS patients, therefore, should be screened and monitored for gastrointestinal symptoms. Corticosteroid treatment seems to be effective in reducing lip enlargement. We discuss the clinical features of this disease, the treatment, and the importance of corticosteroid therapy in cases of MRS-related facial palsy.
Gonçalves
Denise Utsch
DU
Opthalmology, Otorhinolaryngology and Speech Therapy Department, UFMG Medical School, MG, Brazil.
de Castro
Mariana Moreira
MM
Galvão
Cláudia Pena
CP
Brandão
Alexandre Zoni Rodrigues
AZ
de Castro
Míriam Cabral Moreira
MC
Lambertucci
José Roberto
JR
D000293:Adolescent; D002613:Cheilitis / Q000150:complications*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D015552:Injections, Intralesional; D008556:Melkersson-Rosenthal Syndrome / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage
D005938:Glucocorticoids; D014221:Triamcinolone