RESUMO
Orofacial granulomatosis is a nonspecific term that contains a wide variety of granulomatous entities, which share a clinical and histopathological presentation. It manifests as persistent or recurrent orofacial swelling, amongst other findings. Idiopathic orofacial granulomatosis, characterized by an absence of systemic granulomatous disease, is a diagnosis of exclusion. The main differential diagnosis is Crohn's disease. Its pathogenesis is unknown, however, it seems to be immune-mediated. Patch-test sensitivity to multiple allergens is well documented. Currently, therapeutic options consider restrictive diets, topical, intralesional, and systemic agents. First-line therapy is currently a matter of debate. We present a review of the value of diet therapy in this syndrome, along with two illustrative cases.
Assuntos
Granulomatose Orofacial/dietoterapia , Adolescente , Adulto , Granulomatose Orofacial/diagnóstico , Granulomatose Orofacial/patologia , Humanos , Imunoglobulina E/sangue , Masculino , Mucosa Bucal/patologia , Testes Cutâneos , Adulto JovemRESUMO
Abstract: Orofacial granulomatosis is a nonspecific term that contains a wide variety of granulomatous entities, which share a clinical and histopathological presentation. It manifests as persistent or recurrent orofacial swelling, amongst other findings. Idiopathic orofacial granulomatosis, characterized by an absence of systemic granulomatous disease, is a diagnosis of exclusion. The main differential diagnosis is Crohn's disease. Its pathogenesis is unknown, however, it seems to be immune-mediated. Patch-test sensitivity to multiple allergens is well documented. Currently, therapeutic options consider restrictive diets, topical, intralesional, and systemic agents. First-line therapy is currently a matter of debate. We present a review of the value of diet therapy in this syndrome, along with two illustrative cases.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Adulto Jovem , Granulomatose Orofacial/dietoterapia , Imunoglobulina E/sangue , Testes Cutâneos , Granulomatose Orofacial/diagnóstico , Granulomatose Orofacial/patologia , Mucosa Bucal/patologiaRESUMO
Orofacial granulomatosis is a generic term applied to manifestations of several diseases including sarcoidosis, Crohn's disease, Melkersson-Rosenthal syndrome, cheilitis granulomatosa of Miescher, tuberculosis and foreign-body reactions. What bonds these diseases together is the presence of noncaseating granulomas. A typical clinical manifestation of orofacial granulomatosis is recurrent labial swellings that eventually persist. This article describes 2 cases of OG diagnosed with the aid of immunohistochemical analysis and successfully treated with intralesional steroids.
Assuntos
Glucocorticoides/administração & dosagem , Granulomatose Orofacial/tratamento farmacológico , Granulomatose Orofacial/patologia , Doenças Labiais/tratamento farmacológico , Doenças Labiais/patologia , Triancinolona/administração & dosagem , Adulto , Feminino , Humanos , Imuno-Histoquímica , Injeções IntralesionaisRESUMO
A 7-year-old, otherwise healthy Peruvian boy presented with a 3-month history of an indurated centrofacial plaque. Histologic examination revealed a granuloma containing free-living amebae tentatively identified as Balamuthia mandrillaris. The patient failed to respond to tentative treatment. He was admitted to the intensive care unit 7 months later with neurologic manifestations of granulomatous amebic encephalitis, which proved fatal. The difficulty in diagnosing this rare presentation of cutaneous amebiasis, the challenge of treating the condition, and the morbidity and high mortality associated with cerebral involvement are discussed.