[Successful treatment of cheilitis granulomatosis with potent inhibitors of mediator release--possible involvement of mast cells in the pathogenesis].

We report two cases of patients with cheilitis granulomatosis treated successfully with tranilast and ketotifen, both of which are known to be potent inhibitors or mediator release from mast cells. In one patient, complete resolution of the lesion occurred after 1 year of therapy. In another patient, the lesion also showed consistent, if not complete, improvement during the course of therapy. Because of the mechanism of the action, these agents have been widely used as therapeutic modalities for mast-cell-related diseases. We therefore measured numbers of mast cells in the lesions of cheilitis granulomatosis, in comparison with those in mucous cyst and lichen planus. Light microscopy of toluidine-blue-stained sections showed that mast cells, particularly those with ongoing degranulation, increased in number in the reticular dermis of the lesions of cheilitis granulomatosis. These findings suggest that mediators released from mast cells may be critical for the granulomatous inflammation in cheilitis granulomatosis.