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- Title
TRATA MENTUL CHIRURGICAL AL MACROCHEILIEI PERSISTENTE LA UN PACIENT CU SINDROM MELKERSSON-ROSENTHAL OLIGOSIMPTOMATIC.
- Authors
Bálint, Orsolya; Fekete, Gyula-László; Bumbu, Anamaria; Kálmán, Elek-Tamás; Szilveszter, Mónika
- Abstract
Introduction: Melkersson-Rosenthal syndrome is a rare, idiopathic neuromucocutaneous disease. It is characterized by recurrent or persistent orofacial swelling, intermittent peripheral facial nerve paralysis and fissured tongue. In cases of persistent, disfiguring macrocheilia with functional impairment surgical treatment is often required. Clinical case: We report a 38-year-old male patient, who presented for a non-painful, persistent swelling of the lower lip. According to the patient, the current disease started approximatively 20 years ago, with intermittent edema of the lower lip, that progressively became permanent. On physical examination, the patient showed a disfiguring, slightly asymmetric enlargement of the lower lip with labial mucosal eversion and fissured tongue, without facial nerve palsy. Patient underwent Conway's reduction cheiloplasty. Histopathological examination revealed an increased number of dilated blood vessels, a chronic inflammatory infiltrate, a thickened dermis with disorganized collagen bands and the presence of stellate fibroblasts. Based on the history, clinical features and histopathologic findings the diagnosis of oligosymptomatic Melkerrson-Rosenthal syndrome was made. Postoperatively, oral doxycycline 100 mg twice daily was administered for 3 months. At follow-up the patient showed no recurrence of the labial swelling. Discussions: Reduction cheiloplasty is often debated in the literature, stressing the importance of deferring surgery until the disease has been stabilized with conservative therapy, in order to avoid recurrence. In our case, however, due to the disease inactivity, severe aesthetic and functional impairment, surgical treatment was essential. Conclusions: The management of granulomatous cheilitis is often challenging and there is no consensus regarding the preferred therapy. Surgical management through Conway's reduction cheiloplasty followed by oral administration of doxycycline might be a valid therapeutic approach for cases with persistent, severe, disfiguring macrocheilia.
- Publication
Dermatovenerologia Journal, 2019, Vol 64, Issue 3, p181
- ISSN
1220-3734
- Publication type
Article