Granulomatous chelitis of the upper lip in a child

Abstract

Granulomatous cheilitis is a chronic granulomatous inflammatory condition involving the lips with a multifactorial etiology. The difficulty in treatment of granulomatous cheilitis is reflected in various treatments that have been tried and the lack of consensus regarding the preferred treatment. Combined therapy of intralesional corticosteroid and clofazimine or dapsone is one of the most commonly used treatment for the condition. Other treatment options are prednisone,antibiotics such as metronidozole,tetracycline hydroxychloroquine, sulfasalazine, antihistamines, macrolides, thalidomide and infliximab. However, therapeutic responses of patients with granulomatous cheilitis are often unpredictable and spontaneous recurrences are not uncommon .Therefore, an oral physician must carefully proceed in order to develop an accurate treatment planning. Management considerations for these patients depend upon the results of the investigations, patients esthetic considerations and severity of the condition. The most common treatment is intralesional corticosteroids accompanied by other drugs have been used in order to lower the corticosteroid dosage.A case of a nine year old child with the granulomatous cheilitis of upper lip who showed an excellent response to intalesional steroids, metronidazole and doxycycline a combined therapeutic regimen is reported here