title: Cheilitis granulomatosa as an early manifestation of Crohn's disease.
abstract: Cheilitis granulomatosa (CG) is a rare disease, which presents usually as a persistent swelling of the soft tissues in the orofacial region and is characterized histologically by a granulomatous inflammation. We report the case of a 19-year-old man who suffered from anal fistula. The patient had a 6-year history of asymptomatic and persistent swelling of the lower lip. Examinations for gastrointestinal lesions containing double-balloon total enteroscopy revealed erosions located longitudinally throughout the small intestine and the patient was diagnosed Crohn's disease (CD). Biopsy of the lower lip showed non-caseating granuloma and confirmed the diagnosis of CG. Despite an elemental diet and mesalazine therapy, the lip swelling persisted. The CG can be the first presenting symptom of CD. CG as a complication of CD is discussed.
authors.affiliation: Department of Medicine and Molecular Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. toshikoonitake@yahoo.co.jp.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Onitake
authors.affiliation: Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Ueno
authors.affiliation: Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Medicine and Molecular Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Hanaoka
authors.affiliation: Department of Medicine and Molecular Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Yoshioka
authors.affiliation: Department of Medicine and Molecular Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hatakeyama
authors.affiliation: Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.affiliation: Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Health Service Center, Hiroshima University, Higashi-Hiroshima, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Hiyama
authors.affiliation: Department of Medicine and Molecular Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Medicine and Molecular Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kitadai
authors.affiliation: Health Service Center, Hiroshima University, Higashi-Hiroshima, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshihara
authors.affiliation: Department of Medicine and Molecular Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
keywords: Crohn’s disease; Orofacial granulomatosis