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Lee J, Kurien L, Marciano T. Intralesional Injections of a TNF-α Inhibitor to Treat Orofacial Granulomatosis. Inflamm Bowel Dis 2024; 30:499-500. [PMID: 38243814 DOI: 10.1093/ibd/izae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Indexed: 01/22/2024]
Abstract
Lay Summary
We present the first documented case of successful treatment of orofacial granulomatosis by intralesional injections of a tumor necrosis factor α inhibitor to the lip. Our patient had rapid symptomatic improvement after 3 injections, and near resolution within 4 months of anti-tumor necrosis factor α therapy.
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Affiliation(s)
- Jasmine Lee
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, NY, USA
| | - Lisa Kurien
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, NY, USA
| | - Tuvia Marciano
- Department of Pediatrics, NYU Langone Hospital - Long Island, Mineola, NY, USA
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Alessi DM, Azhdam AM, Borrelli M. A Case of Melkersson-Rosenthal Syndrome Treated With 5-FU. Ear Nose Throat J 2021; 100:873S-875S. [PMID: 34448401 DOI: 10.1177/01455613211038391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The rarity of Melkersson-Rosenthal syndrome, or orofacial granulomatosis, can present with persistent midface bogginess. The management for previous reported cases has included corticosteroid injections, antihistamines, and antibiotics. In the current reported case, the patient was treated with 5-fluorouracil and has been responding positively. Additionally, the patient has not shown signs of steroid atrophy.
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Affiliation(s)
| | - Ariel M Azhdam
- 97174Rosalind Franklin University of Medicine and Science, Chicago Medical School, IL, USA
| | - Michela Borrelli
- 22494Cedars Sinai Sinus Center of Excellence, Los Angeles, CA, USA.,Cedars-Sinai Division of Otolaryngology, Los Angeles, CA, USA
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Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2019; 89 Suppl 1:S74-S84. [PMID: 29926944 DOI: 10.1002/jper.17-0719] [Citation(s) in RCA: 306] [Impact Index Per Article: 61.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/11/2018] [Accepted: 03/12/2018] [Indexed: 12/21/2022]
Abstract
Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm-induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable "periodontitis patient" i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a "case" of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.
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Affiliation(s)
- Iain L C Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, UK
| | - Brian L Mealey
- University of Texas Health Science Center at San Antonio, USA
| | | | | | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Oral Medicine, Johann Wolfgang Goethe-University Frankfurt, Germany
| | - Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, USA
| | | | | | - Moshe Goldstein
- Department of Periodontology, Faculty of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Terrence J Griffin
- Periodontal Department, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Palle Holmstrup
- Periodontology, Section 1, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Georgia K Johnson
- Department of Periodontology, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Yvonne Kapila
- Orofacial Sciences, University of California San Francisco, USA
| | - Niklaus P Lang
- Department of Periodontology, University of Bern, Switzerland
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Germany
| | - Shinya Murakami
- Department of Periodontology, Graduate School of Dentistry, Osaka University, Japan
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M College of Dentistry, Dallas, TX, USA
| | - Giuseppe A Romito
- Division of Periodontology, Department of Stomatology, Dental School, University of São Paulo, Brazil
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, Ohio State University, Columbus, OH, USA
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Belgium
| | - Leonardo Trombelli
- Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Italy
| | - Clemens Walter
- Department of Periodontology, Endodontology & Cariology, University Centre for Dental Medicine, University of Basel School of Dentistry, Switzerland
| | - Gernot Wimmer
- Department of Prosthodontics, School of Dentistry, Medical University Graz, Austria
| | - Pinelopi Xenoudi
- Orofacial Sciences, School of Dentistry, University of California San Francisco, USA
| | - Hiromasa Yoshie
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Japan
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Alhazmi K, Berville S, Moyal-Barracco M, Plantier F. [Miescher's granulomatous vulvitis]. Ann Dermatol Venereol 2018; 145:492-499. [PMID: 29884528 DOI: 10.1016/j.annder.2018.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 10/16/2017] [Accepted: 02/05/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Miescher's cheilitis, whether occurring alone or as part of Melkersson-Rosenthal syndrome, is a rare type of granulomatous inflammation of unknown cause with an even rarer genital equivalent. Herein, we describe a case of the latter condition developing over a 12-year period. PATIENTS AND METHODS A 27-year-old woman presented episodes of unilateral vulvar oedema, which initially regressed but resulted over time in permanent vulvar and perineal tumefaction. Histology revealed epithelioid histocytic granulomas so mild that they were not noticed at the start of the disease. The oedema remained the sole sign for 12years and two gastrointestinal screening tests for Crohn's disease proved negative, diagnosis of the latter condition was ruled out. DISCUSSION Miescher's granulomatous vulvitis requires differential diagnosis, essentially with regard to Crohn's disease. Our case illustrates the difficulty in diagnosing this rare disease as well as the uncertainties surrounding its physiopathology. Diagnosis rests upon repeated sampling and biopsies with repeated levels of sections in order to identify the characteristic perivascular granulomas, which may be very mild.
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Affiliation(s)
- K Alhazmi
- Service de pathologie, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France.
| | - S Berville
- Service de dermatologie, hôpital Cochin, pavillon Tarnier, 89, rue d'Assas, 75006 Paris, France
| | - M Moyal-Barracco
- Service de dermatologie, hôpital Cochin, pavillon Tarnier, 89, rue d'Assas, 75006 Paris, France
| | - F Plantier
- Service de pathologie, hôpital Cochin, 27, rue du faubourg Saint-Jacques, 75014 Paris, France
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