Cheilitis granulomatosa (CG) in a child with swollen lips suspicious for oral allergy syndrome: Case report—

Abstract

Here we describe a pediatric case of cheilitis granulomatosa (CG) manifesting as swollen lips that mimicked oral allergy syndrome. A 13-year old girl with a chief complaint of painless swelling of the lips was referred to our outpatient ear, nose, and throat clinic. Histopathology of the first biopsy showed inflammatory changes with infiltration of lymphocytes and plasma cells but no evidence of granuloma. Additional clinical findings from imaging and laboratory examinations led to the diagnosis of CG. Initial conservative treatment reduced the swelling, but it soon recurred. Histopathological findings of granuloma were then found and surgical resection was performed. However, swelling of the lips has repeatedly recurred. CG is a manifestation of orofacial granulomatosis and has features similar to other granulomatous diseases such as Melkersson-Rosenthal syndrome, Crohn’s disease, and sarcoidosis, including histopathologic findings, prognosis, and unclear etiology. CG in children may develop into Crohn’s disease with oral involvement, and therefore long-term systemic follow-up of this condition is recommended.