Is orofacial granulomatosis in children a feature of Crohn's disease?

Abstract

Orofacial granulomatosis is a term generally used to describe lip swelling secondary to an underlying granulomatous inflammatory process. Granulomatous cheilitis is the histopathological description of such inflammation occurring in the lips and surrounding tissues. Melkersson-Rosenthal syndrome (a triad of orofacial swelling, facial paralysis and a fissured tongue) is one manifestation of orofacial granulomatosis, which more commonly presents as granulomatous cheilitis alone. Oral Crohn's disease also belongs to the entity of orofacial granulomatosis. Most reported cases of orofacial granulomatosis have been in adults and some in adolescents. We present six children presenting with orofacial granulomatosis at an early age (range 5-8 y) whose course points towards the development of Crohn's disease.

Conclusion: Orofacial granulomatosis in the paediatric population may be an initial manifestation of Crohn's disease and so careful surveillance is recommended.