Miescher cheilitis is the term used when the granulomatous changes are confined to the lip.
Melkersson-Rosenthal syndrome is a neurological disorder characterized by facial swelling, exceptionally of the lips. It involves nerves, mucous membranes, and skin, especially in orofacial region. Melkersson-Rosenthal syndrome is characterized by oral non-caseating granulomatous lesions, similar to those linked with Crohn disease, sarcoidosis, food allergies, contact allergies, and focal dental sepsis. Miescher cheilitis is generally regarded as a monosymptomatic form of the Melkersson-Rosenthal syndrome.
Although the possibility remains that these may be 2 separate diseases. Melkersson-Rosenthal syndrome is the term used when cheilitis occurs with facial palsy and plicated tongue. Melkersson-Rosenthal syndrome with swellings of hand and foot is rare the cause of Melkersson-Rosenthal syndrome is genetic. Dietary or other antigens are the most common identified cause of orofacial granulomatosis. Contact antigens are sometimes implicated. Treatment is symptomatic and may include medication therapies with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids to reduce swelling, as well as antibiotics and immunosuppressants.
Intralesional corticosteroid (triamcinolone) injections may reduce swelling. Simple compression for several hours daily may produce expressive improvement. Surgery may be recommended to relieve pressure on the facial nerves and to reduce swollen tissue, but its effectiveness has not been established. Long-term penicillin, tetracycline, erythromycin, and ketotifen are other management approaches that are occasionally helpful. Massage and electrical stimulation may also be prescribed. Reduction cheiloplasty with intralesional triamcinolone and systemic tetracycline offer the best results.
