MELKERSSON-ROSENTHAL SYNDROME

Background. Granulomatous cheilitis is a rare chronic swelling of the lip due to granulomatous inflammation. Miescher cheilitis is the term used when the granulomatous changes are confined to the lip. Miescher cheilitis is generally regarded as a monosymptomatic form of the Melkersson-Rosenthal syndrome (SMR). SMR is characterized by a triad, including orofacial swelling, facial palsy and lingua plicata. Aetiology of disease is unknown. Virus infection, several other infectious conditions, allergic reactions and Crohn’s disease may be involved in the aetiology of SMR.Patients and methods. This paper describes a case of 59-yearold male patient with granulomatous cheilitis. Because of swelling of the lip and the cheek allergic patch and prick tests were performed. All tests were negative. Skin biopsy of the affected tissue showed granulomas inflammatory cell infiltration in the dermis. Other systemic granulomatous diseases such a sarcoidosis and tuberculosis were excluded.Results. A systemic therapy with sulphonyldianilyne 50 mg daily was started. After one year a swelling is less visible.Conclusions. SMR needs to be recognized by the clinician with persistent swelling of the lip, chin and cheeks.Their duration is short at first, subsiding completely in a few hours or days, and thus simulating angio-oedema. After recurrent attacks at irregular intervals, the oedema becomes persistent. Full confirmation of the diagnosis of SMR requires a histological examination.