Melkersson-Rosenthal syndrome and cheilitis granulomatosa. A clinicopathological study of thirty-three patients with special reference to their oral lesions.
Thirty-three patients (seventeen females and sixteen males), six with complete and twenty-seven with abortive forms of Melkersson-Rosenthal syndrome (MRS) have been studied. Only patients with histologic granulomatous involvement were included in the study. The onset of MRS occurred predominantly during the second decade of life; the disease had a median duration of 6 1/2 years and a range of 6 months to 31 years. Recurrent lip swelling gradually turning into a permanent enlargement was the dominating sign, but changes in the buccal, palatal, sublingual, and gingival mucosa were frequently recorded as well. Peripheral facial paralysis occurred in 20 percent of the patients and plicated tongue in 40 percent. Laboratory investigations showed no specific changes. The elimination of odontogenic infectious foci was followed by regression or disappearance of the swellings in eleven of sixteen patient, suggesting a pathogenic mechanism. The present study does not seem to justify resections of the swellings when exacerbations are still occurring. A conservative approach is recommended.