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Case Reports
. 2018 Sep 27:2018:bcr2018225682.
doi: 10.1136/bcr-2018-225682.

Idiopathic macrocheilia

Haren Pandya  1 , Hiren Dharmendrabhai Patel  2 , Jigar Mayankbhai Purani  3 , VIvek Ramesh Rayththa  1
Affiliations
Case Reports

Idiopathic macrocheilia

Haren Pandya et al. BMJ Case Rep. .

Abstract

A 13-year-boy presented with painless swelling of upper and lower lips accompanied with gingival enlargement. The aetiology for these symptoms included vast pathological varieties but none of them could fit in. Clinical features were similar to orofacial graulomatosis but histopathological examination revealed chronic non-specific infection. Therefore, the final diagnosis was made as idiopathic macrocheilia through exclusion criteria. Management with intralesional triamcinolone acetonide 40 mg, twice a week for 3 weeks, resulted in significant remission in lip swelling without recurrence after a 6-month follow-up.

Keywords: dentistry and oral medicine; dermatology; drugs and medicines.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preoperative facial profile showing upper and lower lip swelling.
Figure 2
Figure 2
Preoperative lateral profile showing upper and lower lip swelling.
Figure 3
Figure 3
Preoperative gingival enlargement.
Figure 4
Figure 4
Preoperative gingival enlargement.
Figure 5
Figure 5
Intraoral radiograph indicating gemination of lower right central and lateral incisors.
Figure 6
Figure 6
Histopathology picture of mandibular gingiva showing parakeratinised stratified squamous epithelium, dilated blood vessels and inflammatory cell infiltration.
Figure 7
Figure 7
Histopathology picture of maxillary gingiva showing hyperplastic hyperparakeratinised stratified squamous epithelium, dilated blood vessels and inflammatory cell infiltration.
Figure 8
Figure 8
Histopathology picture of lip showing non-keratinised stratified squamous epithelium with vacuolated cells, dilated blood vessels and numerous dilated capillaries.
Figure 9
Figure 9
Intralesional injection 0.1 mL of triamcinolone acetonide (40 mg/dL).
Figure 10
Figure 10
Specimen from maxillary gingiva.
Figure 11
Figure 11
Specimen from mandibular gingiva.
Figure 12
Figure 12
Follow-up after 6 months showing significant remission in lip swelling—facial profile.
Figure 13
Figure 13
Follow-up after 6 months showing significant remission in lip swelling—lateral profile.
Figure 14
Figure 14
Follow-up after 6 months showing reduction in gingival enlargement.
See this image and copyright information in PMC

References

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