title: Onset and progression of clinical manifestations of orofacial granulomatosis.
abstract: BACKGROUND
  There remain few studies describing in detail the early occurrence and long-term progression of clinical manifestations of orofacial granulomatosis (OFG) in a substantial number of patients.
  
  
  OBJECTIVE
  The aim of this study was to determine the early and late clinical manifestations of a large case series of patients with OFG.
  
  
  METHODS
  Clinically relevant data of 49 patients with OFG who attended an Oral Medicine unit in the UK were examined retrospectively. The analyzed parameters included occurrence and typology of initial manifestations at onset and with respect to long-term follow-up.
  
  
  RESULTS
  Five major patterns of disease onset were observed. Recurrent facial swelling with/without intra-oral manifestations was the single most common presentation at onset followed by intra-oral ulcers, and other intra-oral and neurological manifestations. The majority of patients later developed a spectrum of additional features.
  
  
  CONCLUSIONS
  OFG results in multiple manifestations at different time points. The disease onset is characterized by manifestations other than facial swelling in about half of affected individuals. However, patients can develop cosmetically unacceptable lip/facial swelling at a later stage. Nearly all affected individuals ultimately develop lip/facial swelling while about half of all patients develop oral ulceration.
authors.affiliation: Oral Medicine, UCL Eastman Dental Institute, London, UK. k.aljohani@eastman.ucl.ac.uk
authors.forename: K
authors.initials: K
authors.lastname: Al Johani
authors.forename: D R
authors.initials: DR
authors.lastname: Moles
authors.forename: T
authors.initials: T
authors.lastname: Hodgson
authors.forename: S R
authors.initials: SR
authors.lastname: Porter
authors.forename: S
authors.initials: S
authors.lastname: Fedele
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D004487:Edema / Q000145:classification / Q000209:etiology* / Q000473:pathology; D005145:Face / Q000473:pathology; D005260:Female; D051261:Granulomatosis, Orofacial / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019226:Oral Ulcer / Q000209:etiology* / Q000473:pathology; D055815:Young Adult