Last update:
12-May-2011

Orofacial granulomatosis (OFG) usually presents as a persistent swelling of the soft tissues of the orofacial area, mainly the lips, and is characterized histologically by non-specific granulomatous inflammation. A 16-year-old male was referred to the Dental School of the University of Athens, for evaluation of persistent swelling of the lips and multiple painful oral lesions of 6 months duration. Clinical examination revealed diffuse swelling of both lips, exfoliative cheilitis, multiple nodules, fissures and ulcers in the oral cavity. The diagnostic biopsies showed granulomatous inflammation with no signs of a foreign body or fungi. The diagnostic procedure involved hematological tests, chest X-ray and gastroenterological consultation to rule out systemic diseases. The final diagnosis was OFG. The patient was treated with topical corticosteroids in the form of injections and ointments. After 3 weeks of treatment, the lesions had disappeared and the patient reported no further symptoms. The etiopathogenesis of OFG remains unclear. Genetic factors, infections, allergies and immunological factors have all been identified as possible causes. The relationship between OFG and Crohn's disease requires further research. OFG presents a wide spectrum of clinical manifestations with both extraoral and intraoral signs (soft tissue swelling, ulcers, nodules, fissured tongue), as well as neurological signs (such as paralysis of the facial nerve and xerostomia). Many systemic diseases can simulate the clinical appearance of OFG. Differential diagnosis requires great attention and experience. The treatment of OFG consists mainly of topical and systemic corticosteroids.

Key words: Orofacial granulomatosis.