Cheilitis Granulomatosa: A Case Report with Review of Literature
A 43-year-old woman patient presented with persistent, painful upper lip swelling since one week []. There was no history of applied irritants, local trauma or atopy. She also reported burning and peeling off in perioral area. Past history revealed that patient had been treated for similar condition with various different modalities including ayurvedic medication, homeopathy and topical steroids in past three years. On examination the upper lip and perioral area showed painful swelling, with areas of crusting and fissuring []. Neither facial nerve palsy nor fissuring of the tongue nor lymph node involvement was present. No such lesions were seen intraorally.\nThe biopsy revealed hyperplastic epithelium of variable thickness covered by fibrinopurulent exudate []. The superficial lamina propria was loose and edematous. The underlying fibrocellular connective tissue revealed with abundant non caseating granulomas with Langhans type multinucleated giant cells and perivascular lymphocyte aggregations []. In other investigations, chest radiograph showed no abnormalities, and a Mantoux test was non-reactive. Evaluation for food allergies revealed higher allergen quantity for the following food items (normal range being 0-0.35 Ku/L):\nAlmond: 1.90\nCashew nut: 1.30\nUrad dal: 1.30\nRajma: 1.20\nCabbage: 1.80\nTomato: 2.00\nFrom all these findings a diagnosis of CG secondary to certain food items was made.