Two Cases of Cheilitis Granulomatosa

OHASHI Norio, KANTO Hiromi, IWABUCHI Chikako, HASHIMOTO Yuki, IWASE Nanae, ITOH Masatoshi

doi:10.2336/nishinihonhifu.71.137

Case 1: The patient was a 38-year-old male who developed a swollen lower lip after treatment for a decayed tooth. Histological examination revealed epithelioid cell granuloma, and he was diagnosed with cheilitis granulomatosa. Result of a patch test for urushiol was positive. Treatment with fexofenadine hydrochloride (120 mg/day) was initiated, and 10 months later, the lesion had improved. Case 2: The patient was a 31-year-old male who had experienced a swollen upper lip for two months. He underwent treatment for pyorrhea before he visited our hospital, but the lesion had not improved. Histological examination revealed epithelioid cell granuloma, and the patient was diagnosed as having cheilitis granulomatosa. He had many metal dental fillings and six post crowns. Results of patch tests for nickel sulfate and para-phenylendiamine were positive. Predonisolone (5 mg/day) and olopatadine hydrochloride (10 mg/day) were administered, and the lesion had improved one month after the start of this treatment. However, the metal dental workcould not be removed. It has been proposed that cheilitis granulomatosa is an incomplete form of Melkersson-Rosenthal syndrome. Based on previous case reports, we compared these two diseases and found that cheilitis granulomatosa is frequently associated with dental diseases or allergies to dental metals and responds better to therapy than does Melkersson-Rosenthal syndrome.

Two Cases of Cheilitis Granulomatosa

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