Transitional Year Program, San Antonio Uniformed Services Health Education Consortium, Brooke Army Medical Center, San Antonio, TX.
Flight Medicine, Department of Dermatology, Tinker Air Force Base, Oklahoma City, OK; and.
Am J Dermatopathol. 2023 Jul 1;45(7):482-486. doi: 10.1097/DAD.0000000000002458.
We describe a 20-year-old male with no significant medical history who presented with a 1-month history of painless upper and lower lip edema initially treated with antibiotics for suspected cellulitis before arriving to the clinic. After a failed response to that treatment, a lip biopsy was eventually performed and consistent with a diagnosis of granulomatous cheilitis. In addition to oral and topical corticosteroids and tacrolimus, the patient adopted the cinnamon- and benzoate-free diet with some improvement of his lip swelling. Persistent mild tachycardia led to a cardiology referral for further evaluation and sarcoidosis workup. A gastroenterology consult was placed to correlate his presentation with Crohn's disease. The cardiology workup was noncontributory, and the patient was ultimately diagnosed with Crohn's disease after evaluation with laboratory studies and colonoscopy. This case highlights the need to evaluate for Crohn's disease in patients who present with granulomatous cheilitis, even in the absence of gastrointestinal symptoms, and the potential benefit of incorporating a cinnamon- and benzoate-free diet in treatment.
我们描述了一名 20 岁男性，无明显病史，最初因疑似蜂窝织炎接受抗生素治疗 1 个月，出现无痛性上下唇肿胀，随后就诊。在最初的治疗失败后，最终进行了唇部活检，符合肉芽肿性唇炎的诊断。除了口服和局部皮质类固醇和他克莫司外，患者还采用了不含肉桂和安息香酸的饮食，嘴唇肿胀有所改善。持续轻微心动过速导致心内科转诊进一步评估和结节病检查。由于与克罗恩病相关，还请了消化内科会诊。心内科检查无明显异常，最终通过实验室研究和结肠镜检查诊断为克罗恩病。本病例强调了即使没有胃肠道症状，对于出现肉芽肿性唇炎的患者也需要评估是否患有克罗恩病，以及在治疗中采用不含肉桂和安息香酸的饮食可能带来的益处。
