Department of Maxillo-Facial surgery, University of Siena Faculty of Medicine and Surgery, Siena, Italy
Department of Maxillo-Facial surgery, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
BMJ Case Rep. 2023 May 23;16(5):e251829. doi: 10.1136/bcr-2022-251829.
Macrocheilia, or lip enlargement, has a varied aetiology, but granulomatous conditions, both infective and non-infective, comprise a significant proportion of patients. Diagnosis starts with clinical investigations while histological examination is required for a definitive diagnosis. In the case presented, a young man presented with painless swelling of upper lip over the past 3 months. Given the clinical history and biopsy results, the diagnosis of granulomatous cheilitis was made which is considered a rare manifestation of metastatic Crohn's disease. Treatment options remain debated, though in the situation presented a conservative approach was adopted, consisting of antibiotics and corticosteroid therapy, which resulted in significant remission in lip swelling without recurrence after a 3-month follow-up.
巨唇症,或唇部肿大,病因多样,但肉芽肿性疾病,包括感染性和非感染性疾病,占患者的很大一部分。诊断始于临床检查,而组织学检查则是明确诊断所必需的。在本例中,一名年轻男性在过去 3 个月出现无痛性上唇肿胀。鉴于临床病史和活检结果,诊断为肉芽肿性唇炎,这被认为是克罗恩病转移性的罕见表现。治疗选择仍存在争议,尽管在本例中采用了保守治疗方法,包括抗生素和皮质类固醇治疗,这导致唇部肿胀显著缓解,随访 3 个月后无复发。