Oro facial Granulomatous

Question 1

What is a granulomas comprised of?

Answer 1

CORE:
- Macrophages and epithelioid cells
MARGINAL RIM:
- chronic inflammatory cells, mainly lymphocytes and outer fibrosis

Question 2

What is granulomatosis with polyangiitis?

Answer 2

• Uncommon multisystem chronic granulomatous disease of unknown cause
• Affects respiratory tract, inflammation of small blood vessels and necrotising glomerulonephritis
• Oral features = hyperplastic gingiva, tooth mobility, parotid gland swelling, palatal swelling

Question 3

What is the clinical presentation of oro-facial granulomatosis?

Answer 3

o Lip swelling
o Cobble stoning of buccal mucosa
o Erythema of gingivae
o Gingival hyperplasia
o Slit like ulcers
o Stag horning of submandibular ducts
o Tissue tags

Question 4

What is the management of oro facial granulomatosis?

Answer 4

• Dietary restriction (cinnamon and benzoate free)
• Topical agents
• Intra-lesional corticosteroids (prednisone)
• Immunosupression
• Immunomodulation