Miescher's cheilitis granulomatosa, two case reports and diagnostic approach to lip swelling

Granulomatous cheilitis is a rare inflammatory condition, characterized by a consistent painless swelling of one or both lips, it is considered a monosymptomatic form of Melkersson-Rosenthal syndrome. Its etiology has not been clearly established, but the underlying process is a granulomatous infiltration and sometimes fibrosis. Differential diagnosis may include other granulomatous disorders with chronic lip swelling, Melkerson-Rosenthal syndrome, Glandular cheilitis, and Dental abscess. In this paper we report our approach to diagnose and treat two cases of cheilitis granulomatosa, and we propose an algorithm to lip swelling diagnosis.