The Australasian Society of Clinical Immunology and Allergy

Orofacial granulomatosis (OFG: also known as Melkersson-Rosenthal syndrome, Cheilitis Granulomatosis, and Schuermann's Glossitis Granulomatosa) is an uncommon inflammatory condition effecting the face and lips. People of all ages can be affected, but it is most common in the early adult years.

Lip swelling is common

Lip swelling initially may only last a few hours at a time, and can be difficult to distinguish from another type of lip swelling known as angioedema. As the condition progresses, swelling tends to last for days at a time, and eventually becomes permanent. Sometimes cracking and dryness of the lips occurs.

Other common symptoms

Swelling of the face and eyes also occurs. Some effected individuals have a "fissured tongue", and may sometimes develop facial paralysis. Mouth ulcers and inflammation of the gums, known as gingivitis is sometimes seen. Other symptoms include tongue swelling or a sensation of a burning tongue. Occasionally facial numbness, cheek and gum swelling can develop.

Orofacial granulomatosis (OFG) is an inflammatory disease

Swelling and inflammation is seen in involved tissues, with clumps of many different types of white cells. While inflammation has been blamed on various infections from time to time, there is no definite proof that OFG is due to any one infectious organism. The cause of OFG is unknown.

Confirming the diagnosis

As there are many possible causes of lip swelling, tests are often required to prove the diagnosis, and to exclude diseases that can mimic OFG. These tests may include blood tests, taking a sample of the involved tissue ("biopsy"), or sometimes x-rays or other specialized tests.

Treatment

Sometimes swellings will resolve spontaneously without treatment, but most persist for many years. While no one treatment is always effective, a number of options are available. These include:

• Elimination diets
• Medications that reduce inflammation
• Radiotherapy
• Plastic Surgery.

© ASCIA 2003
The Australasian Society of Clinical Immunology and Allergy (ASCIA) is the peak professional body of Clinical Allergists and Immunologists in Australia and New Zealand.

Disclaimer:

ASCIA Education Resources (AER) information bulletins have been peer reviewed by ASCIA members and represent the available published literature at the time of review .

It is important to note that information contained in this bulletin is not intended to replace professional medical advice. Any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner.

Content Last updated 1 April 2003