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Correspondence |

Atypical Gingivitis Heralding a Case of Orofacial Granulomatosis

John R. Griffin, MD; Rochelle R. Torgerson, MD, PhD; Alison J. Bruce, MB, ChB
Arch Dermatol. 2012;148(1):139-140. doi:10.1001/archdermatol.2011.992.
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Orofacial granulomatosis is a disorder of the orofacial soft tissues characterized clinically by recurrent to persistent lip and facial swelling and histopathologically by noncaseating granulomatous inflammation, lymphangiectasia, and perivascular lymphocytic inflammation.1,2 It is a diagnosis of exclusion considered to represent a spectrum of clinical entities including cheilitis granulomatosa and Melkersson-Rosenthal syndrome. We describe herein a case of granulomatous stomatitis presenting with atypical gingivitis consistent with orofacial granulomatosis. Since granulomatous stomatitis may be a marker for systemic disease, it is imperative to rule out other potentially associated conditions.

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Figure 1. Buccal mucosa. A, Uninvolved right buccal mucosa. B, Poorly circumscribed swelling and orange-yellow discoloration of the left buccal mucosa, the site of disease activity.

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Figure 2. Chronic mucositis with submucosal edema and focal noncaseating granulomas (hematoxylin-eosin, original magnification ×4). Findings of periodic acid –Schiff diastase and acid-fast bacilli stains were negative for microorganisms.

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