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Signs and Symptoms of Orofacial Granulomatosis:
- Persistent or recurrent enlargement of the lips, causing them to protrude
- Midline fissuring of the lip (median cheilitis) or angular cheilitis (sores at the corner of the mouth)
- Oral ulceration (mouth ulcers) which may be aphthous-like or chronic and deep
- Full width gingivitis
- Fissured tongue
Causes and Associations of Orofacial Granulomatosis:
- Unknown cause
- Non-caseating granulomatous inflammation
- Disagreement on whether it represents an early form of Crohn's disease or sarcoidosis
- Possible association with oral Crohn's disease
- Suspected sources of antigens include metals and additives/preservatives in foods
Diagnosis of Orofacial Granulomatosis:
- Usually diagnosed through tissue biopsy
- Cannot reliably distinguish between OFG, Crohn's disease, or sarcoidosis
- Other causes of granulomatous inflammation are ruled out
Classification of Orofacial Granulomatosis:
- OFG could be classified as a type of cheilitis and a granulomatous condition
Treatment of Orofacial Granulomatosis:
- Anti-tumor necrosis factor α drugs (e.g. infliximab)
- Dietary restriction of suspected or proven antigens
- Management may involve cinnamon or benzoate-free diets