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Sitenga G, Granger P, Marvin E, Anderson K, Davis D, Hand J, Tollefson M. Granulomatous cheilitis in children: three cases successfully treated with intralesional corticosteroids. Int J Dermatol 2023; 62:e238-e239. [PMID: 35385127 DOI: 10.1111/ijd.16201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/05/2021] [Accepted: 03/21/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | - Peter Granger
- Creighton University School of Medicine, Omaha, NE, USA
| | | | - Katelyn Anderson
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Dawn Davis
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jennifer Hand
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Megha Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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Gavioli CF, Florezi GP, Lourenço SV, Nico MM. Clinical Profile of Melkersson-Rosenthal Syndrome/Orofacial Granulomatosis: A Review of 51 Patients. J Cutan Med Surg 2021; 25:390-396. [PMID: 33573395 DOI: 10.1177/1203475421995132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Melkersson-Rosenthal syndrome (MRS) is a rare disease characterized by the triad of granulomatous cheilitis, fissured tongue, and facial paralysis. Publications concerning large series are rare in the literature. OBJECTIVES To describe the clinical and histopathological characteristics of patients with complete and oligosymptomatic forms of MRS. METHODS A retrospective records review was performed for the diagnoses of Melkersson-Rosenthal syndrome, granulomatous cheilitis, and orofacial granulomatosis at oral Diseases Clinic of the Department of Dermatology, University of São Paulo, Brazil (2003, 2017). RESULTS A total of 51 patients were included, mean age at presentation 35.69 years. Four patients were younger than 18 years. The complete triad of was observed in 10 patients. The rare findings of granulomatous blepharitis, gingivitis and palatitis are presented. Comorbidities included Crohn's disease (5 patients), migraine headaches (1 patient) and convulsions (2 patients). Granulomatous inflammatory infiltrate was detected in 31 biopsies. Medical therapies included included oral and intralesional steroids, thalidomide, dapsone, azathioprine, tetracycline, methotrexate, and surgery, with variable responses. CONCLUSIONS Our report meant to draw attention to the clinical spectrum of this rare disorder, mainly to oligosymptomatic forms and rarer presentations.
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Affiliation(s)
- Camila Fb Gavioli
- Department of Dermatology, Medical School, Av. Dr. Eneas de Carvalho Aguiar 255, Brazil1
| | - Giovanna P Florezi
- 28133 Department of Pathology, Dental School, University of São Paulo- Brazil, Brazil
| | - Silvia V Lourenço
- 28133 Department of Pathology, Dental School, University of São Paulo- Brazil, Brazil
| | - Marcello Ms Nico
- Department of Dermatology, Medical School, Av. Dr. Eneas de Carvalho Aguiar 255, Brazil
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Wang S, Wang H, Shi X, Wu F, Lv L, Hu M, Sun W, Wu L, Zhou H. A case of Melkersson-Rosenthal syndrome with endocrine disorders: Extraordinary efficiency of hydroxychloroquine and mechanism hypothesis. Eur J Neurol 2020; 28:928-933. [PMID: 33270950 DOI: 10.1111/ene.14615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/17/2020] [Accepted: 10/22/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Melkersson-Rosenthal syndrome (MRS) is a rare neuro-mucocutaneous disease. In addition to the traditional clinical triad, there is also a diversity of clinical signs, and it may be related to other systemic diseases. METHODS In the present study, we report a case of MRS with endocrine disorders that exhibits extraordinary therapeutic efficiency by using hydroxychloroquine (HCQ), explore whether there is an internal connection between MRS and endocrine disorders, and discuss the mechanism of the therapeutic efficiency of using HCQ. The hypothesis proposed for the first time is that MRS may essentially be a systemic granulomatous disease. RESULTS The physical examination revealed orofacial swelling and fissured tongue. The histopathologic examination showed epithelioid granulomas. Combined with the other examination, this case was diagnosed as incomplete MRS. HCQ and local drugs were introduced. The patient achieved clinical recovery and psychological cure by the 18-week follow-up, and the 1-year follow-up found no reactivation of MRS. Moreover, the levels of cortisol and adrenocorticotropic were within normal ranges. CONCLUSIONS After the drug therapy was targeted at granuloma, not only did all of the symptoms related to MRS disappear, but the endocrine system also returned to normal. It is speculated that the endocrine disorder in this patient may be related to MRS. We further propose the first-time hypothesis that MRS may essentially be a systemic granulomatous disease. It provides a new medication method with high-level efficiency.
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Affiliation(s)
- Shimeng Wang
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Hongmei Wang
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.,Mianyang Stomatological Hospital, Mianyang, China
| | - Xueke Shi
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Fanglong Wu
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Ling Lv
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Mingjia Hu
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Wanxin Sun
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Lanyan Wu
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hongmei Zhou
- State Key Laboratory of Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
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Kumekawa M, Yamamoto T. Cheilitis granulomatosa in a child with juvenile periodontal disease. J Dermatol 2020; 47:e397-e398. [DOI: 10.1111/1346-8138.15538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/07/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Muneyuki Kumekawa
- Department of Dermatology Fukushima Medical University Fukushima Japan
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Premjeyanth V, Shipman AR, Shipman KE. Faecal calprotectin in dermatology practice. Clin Exp Dermatol 2020; 45:831-835. [DOI: 10.1111/ced.14307] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 12/17/2022]
Affiliation(s)
| | - A. R. Shipman
- Dermatology Department St Mary’s Hospital Portsmouth UK
| | - K. E. Shipman
- Department of Clinical Chemistry St Richards Hospital Chichester UK
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Melkersson-Rosenthal syndrome - a therapeutically challenging disease. Postepy Dermatol Alergol 2020; 38:533-536. [PMID: 34377141 PMCID: PMC8330875 DOI: 10.5114/ada.2020.92569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 10/17/2019] [Indexed: 11/17/2022] Open
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Jácome-Santos H, Resende RG, Silva AMB, Cruz AF, Tanos de Lacerda SH, Mesquita RA, Tanos de Lacerda JC. Low-level laser as a complementary therapy in orofacial granulomatosis management: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:e1-e5. [DOI: 10.1016/j.oooo.2019.02.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/03/2019] [Accepted: 02/23/2019] [Indexed: 12/20/2022]
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Savasta S, Rossi A, Foiadelli T, Licari A, Elena Perini AM, Farello G, Verrotti A, Marseglia GL. Melkersson⁻Rosenthal Syndrome in Childhood: Report of Three Paediatric Cases and a Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071289. [PMID: 30974872 PMCID: PMC6479526 DOI: 10.3390/ijerph16071289] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/02/2019] [Accepted: 04/09/2019] [Indexed: 11/16/2022]
Abstract
Melkersson–Rosenthal syndrome (MRS) in children is a rare condition, clinically characterised by a triad of synchronous or metachronous symptoms: recurrent peripheral facial palsy, relapsing orofacial oedema, and a fissured tongue; the most recent review published on the topic has reported 30 published patients. The aetiology of this disease is still unclear. However, genetic factors, as well as alterations in immune functions, infections, and allergic reactions have been postulated. We report three children suffering from MRS and perform a literature review of paediatric cases. Taking into account that clinical and laboratoristical criteria for the diagnosis of MRS are lacking, this syndrome is probably underestimated, and we suggest increasing awareness of such a rare syndrome. Close multidisciplinary follow-up of these children with a team composed by paediatricians, neurologists, neuro-ophthalmologists, dermatologists, and otolaryngologists is crucial to guarantee exhaustive management and treatment success, while minimising relapses.
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Affiliation(s)
- Salvatore Savasta
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | - Alessandra Rossi
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | - Thomas Foiadelli
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | - Amelia Licari
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
| | | | - Giovanni Farello
- Pediatric Clinic⁻Department of Life, Health and Environmental Sciences⁻Piazzale Salvatore Tommasi 1, 67100 Coppito (AQ), Italy.
| | - Alberto Verrotti
- Pediatric Clinic⁻Biotechnological and Applied Clinical Sciences Via Vetoio (Coppito 2), 67100 Coppito (AQ), Italy.
| | - Gian Luigi Marseglia
- Pediatric Clinic Fondazione IRCCS Policlinico San Matteo⁻V.le Golgi, 19 Pavia, Italy.
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