OFG

Question 1

What is OFG?

Answer 1

Orofacial Granulomatosis
Uncommon chronic inflammatory disorder
Idiopathic or associated with systemic granulomatous conditions (Crohn’s or sarcoidosis)

Question 2

What is the average age of onset for OFG?

Answer 2

11 years old

Question 3

What is the characteristic pathology of OFG?

Answer 3

Non caseating giant cell granulomas which then result in lymphatic obstruction

Question 4

What are the characteristic features of OFG?

Answer 4

Lip swelling
Full thickness gingival swelling
Swelling of the non labial facial tissues
Peri-oral erythema
Cobblestone of the buccal mucosa
Linear oral ulceration
Mucosal tags
Lip/tongue fissuring
Angular cheilitis

Question 5

What is the aetiology of OFG?

Answer 5

Largely unknown
Limited evidence of genetic factors
Allergens- cinnamon, benzoates

Question 6

What are the investigations for OFG?

Answer 6

Measure growth: Delays seen in Crohn’s
Full blood count
Haematinics
Patch testing
Diet diary
Faecal calprotectin -Crohn’s
Serum Angiotensin Converting Enzyme (for sarcoidosis)

Question 7

What is the management for OFG?

Answer 7

Difficult
Oral hygiene support
Symptomatic relief for ulceration
Dietary exclusion
Topical steroids
Topical tacrolimus
Short courses of oral steroids
Intralesional corticosteroids