Presentation
[1] The classic presentation of OFG is a nontender recurrent labial swelling that eventually becomes persistent.[2] However, the clinical presentation can be highly variable, making the diagnosis difficult to establish.[3] We report the case of a 61- [ncbi.nlm.nih.gov]
Oral manifestations have a prevalence ranging from 20 to 50%, and initial presenting signs occur in 5-10% of affected patients (fig. 1a). [karger.com]
When it involves the mouth alone, some authors refer to this as "oral Crohn disease", distinguishing it from OFG, and others suggest that OFG is the same condition as Crohn disease when it presents in the oral cavity. [en.wikipedia.org]
Immune System
- Cervical Lymphadenopathy
] The patient represented a case of idiopathic OFG with histopathologically proven noncaseating granulomas involving the lower lip mucosa, tongue, and the oral cavity with cervical lymphadenopathy. [ncbi.nlm.nih.gov]
The facial skin may be dry, exfoliative (flaking) or erythematous.[2] Cervical lymphadenopathy (enlarged lymph nodes in the neck).[2] Facial palsy (weakness and altered sensation of the face).[2] The enlargement of the tissues of the mouth, lips and face [en.wikipedia.org]
Entire Body System
- Falling
Wir berichten über einen Fall von OFG, die einen atypischen und monosymptomatischen Beginn zeigte mit einer generalisierten hyperplastischen Gingivitis, die anderen fazilen und mukosalen Symptomen mehrere Wochen vorausging. [onlinelibrary.wiley.com]
- Lymphedema
[…] protease-activated receptors, matrix metalloproteinases and cyclooxygenases.[6] The granulomas in OFG form in the lamina propria, and may form adjacent to or within lymphatic vessels.[8] This is thought to cause obstruction of lymphatic drainage and lymphedema [en.wikipedia.org]
- Soft Tissue Swelling
Abstract Orofacial granulomatosis is a rare chronic inflammatory disorder characterized by persistent or recurrent soft tissue swellings, oral ulceration, and other orofacial features in the absence of an identifiable granulomatous disease. [ncbi.nlm.nih.gov]
Jaw & Teeth
- Xerostomia
In the maxillofacial region, the salivary glands are often involved, and this may cause xerostomia or bilateral parotid swelling [23,24,25]. The involvement of the oral cavity seems to be rare with an unknown prevalence. [karger.com]
- Gingival Recession
These lesions were localized swellings or nodules (n = 34; fig. 1b), ulcers (n = 4), swelling with multiple ulcers (n = 2), gingivitis (n = 3), gingival hyperplasia (n = 3) and gingival recession (n = 1). [karger.com]
- Gingival Swelling
These lesions were localized swellings or nodules (n = 34; fig. 1b), ulcers (n = 4), swelling with multiple ulcers (n = 2), gingivitis (n = 3), gingival hyperplasia (n = 3) and gingival recession (n = 1). [karger.com]
Eyes
- Blepharospasm
MRS is also associated with some other syndromes, including trigeminal neuralgia, paresthesias, ocular palsies, blepharospasm, epiphora, keratitis, psychotic episodes, uveitis and migraine [42,43]. [karger.com]
Skin
- Papule
The lesions often appear as mucosal-colored papules that produce firm plaques on the buccal mucosa and palate. These lesions are pathognomonic for CD but are not associated with intestinal CD activity [17,18]. [karger.com]
Psychiatrical
- Suggestibility
The precise cause of OFG is still unknown, although several theories have been suggested, such as infection, hereditary factors and allergy. [karger.com]
When it involves the mouth alone, some authors refer to this as "oral Crohn disease", distinguishing it from OFG, and others suggest that OFG is the same condition as Crohn disease when it presents in the oral cavity. [en.wikipedia.org]
At present, it is suggested that both orofacial granulomatosis and oral Crohn's disease appear to be distinct clinical disorders. [ncbi.nlm.nih.gov]
Workup
Colonoscopy
- Multiple Ulcerations
These lesions were localized swellings or nodules (n = 34; fig. 1b), ulcers (n = 4), swelling with multiple ulcers (n = 2), gingivitis (n = 3), gingival hyperplasia (n = 3) and gingival recession (n = 1). [karger.com]
Treatment
However, rare spontaneous remission is possible.[6,15] First line treatment involves the use of local or systemic corticosteroids or both.[6] Other alternative treatment agents have been reported in the literature including hydroxychloroquine, methotrexate [ncbi.nlm.nih.gov]
The treatment of MRS is controversial. Various modes of treatment have been proposed, including nonsteroidal antiinflammatory drugs, antibiotics, antihistamines, lymecycline, systemic and intralesional corticosteroids and methotrexate [47,48,49]. [karger.com]
Oral and maxillofacial medicine : the basis of diagnosis and treatment (3rd ed.). Edinburgh: Churchill Livingstone. pp. 298–301. ISBN 9780702049484. ^ Zbar, AP; Ben-Horin, S; Beer-Gabel, M; Eliakim, R (March 2012). [en.wikipedia.org]
Etiology
Hence, more studies are needed to clarify the role of this spirochete as an etiological factor of OFG. [karger.com]
[…] been implicated in inducing tissue changes consistent with OFG.[14] The cause can be a protracted one, ranging over many years.[9] The treatment of OFG is difficult, particularly in the absence of an etiologic factor. [ncbi.nlm.nih.gov]
Epidemiology
Treatment[edit] Anti-tumour necrosis factor α drugs (e.g. infliximab) [10] Dietary restriction of a particular suspected or proven antigen may be involved in the management of OFG, such as cinnamon or benzoate-free diets.[8] Epidemiology[edit] OFG is [en.wikipedia.org]
A comparative epidemiological study. Sarcoidosis 1995;12:61-67. Rossman MD, Thompson B, Frederick M, et al: HLA-DRB1*1101: a significant risk factor for sarcoidosis in blacks and whites. Am J Hum Genet 2003;73:720-735. [karger.com]
Prevention
Early diagnosis of OFG is a crucial step to prevent and cure its unsightly sequelae and sometimes avoid progression of systemic potentially life-threatening OFG-related diseases. [onlinelibrary.wiley.com]
Spencer AJ: An evidence-based approach to the prevention of oral diseases. Med Princ Pract 2003;12(suppl 1):3-11. Zhang YZ, Li YY: Inflammatory bowel disease: pathogenesis. World J Gastroenterol 2014;20:91-99. [karger.com]