Buccal localization of Crohn's disease with long-term infliximab therapy: a case report.

Abstract

INTRODUCTION:

Cheilitis granulomatosa causes persistent idiopathic lip swelling and ulceration and it can sometimes be recognized as a unique or early manifestation of Crohn's disease. Spontaneous remission is rare and with the lack of controlled trials, different therapeutic approaches have been used. Some cases have been treated with an exclusion diet in the attempt to rule out diet allergens, while the most popular treatments include antibiotics such as tetracycline and clofazimine tranilast, benzocaine topical or intralesional steroids, and cheiloplasty, with different outcomes.

CASE PRESENTATION:

We describe the case of a 23-year-old Caucasian man, primarily diagnosed with cheilitis granulomatosa for a severe lower lip swelling, and then with Crohn's disease of the terminal ileum and anus. Treatment of Crohn's disease with an anti-tumor necrosis factor alpha agent (infliximab) successfully induced remission of both the gastrointestinal disease and the oral lesion.

CONCLUSIONS:

Our recommendation is that physicians should be able to recognize cheilitis granulomatosa as a possible marker of a more complex systemic disease and proceed first with an accurate physical examination, and further suggest investigations of the bowel. In cases of Crohn's disease, a therapy with biological agents can be successful.

• Authors: Carolina Ciacci, Cristina Bucci, Fabiana Zingone, Paola Iovino, Massimo Amato
• Journal: Journal of medical case reports (J Med Case Rep) Vol. 8 Pg. 397 (Nov 30 2014) ISSN: 1752-1947 [Electronic] England
• PMID: 25433368 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Antibodies, Monoclonal
• Infliximab

Topics

• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Colonoscopy
• Crohn Disease (complications, diagnosis, drug therapy)
• Humans
• Infliximab
• Male
• Melkersson-Rosenthal Syndrome (diagnosis, drug therapy, etiology)
• Remission Induction
• Young Adult