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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 50-51

Orofacial granulomatosis - Intralesional steroid therapy


Department of Oral Medicine & Radiology, Mamata Dental College & Hospital, Khammam 507 002, Telangana, India

Date of Submission17-Oct-2019
Date of Web Publication25-May-2021

Correspondence Address:
Kotya Naik Maloth
Department of Oral Medicine & Radiology, Mamata Dental College & Hospital, Khammam 507 002, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1801_19

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How to cite this article:
Reddy Kundoor V, Maloth KN. Orofacial granulomatosis - Intralesional steroid therapy. Indian J Med Res 2020;152, Suppl S1:50-1

How to cite this URL:
Reddy Kundoor V, Maloth KN. Orofacial granulomatosis - Intralesional steroid therapy. Indian J Med Res [serial online] 2020 [cited 2021 Aug 4];152, Suppl S1:50-1. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/50/316732

Patient's consent obtained to publish clinical information and images.


A 55 yr old female presented to the department of Oral Medicine and Radiology, Mamata Dental College, Khammam, Telangana, India, in June 2019, with the complaints of progressive swelling on her lower and middle third part of the face for the last four years. No history of food allergy was recorded.

On extra-oral examination, a diffuse swelling was seen on her lower and middle third of the face, involving upper lip, lower lip, chin and cheek region. Skin over the swelling was slightly erythematous with shiny surface, firm and non-tender [Figure 1]A. On intra-oral examination, generalized oedematous and erythematous gingiva was noted. Swelling involving the labial mucosa of both upper and lower lips and right and left buccal mucosa was seen. On palpation, it was firm and non-tender [Figure 1]B. Baseline investigations were non-contributory. Incisional biopsy was done with respect to upper lip. Haematoxylin and eosin-stained histopathology pictures revealed that superficial lamina propria consists of areas of non-caseating granulomas along with dilated blood capillaries and lymphocytes, suggestive of orofacial granulomatosis [Figure 2].
Figure 1: (A) Swelling on her lower and middle third of the face (arrows). (B) generalized oedematous and erythematous gingiva with respect to both upper and lower arch (arrows).

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Figure 2: Haematoxylin and eosin-stained histopathology pictures revealed (A) non-caseating granulomas along with dilated blood capillaries (yellow arrow) and lymphocytes (×10). (B) non-caseating granulomas are surrounded by histocytes (green arrow), lymphocytes (yellow arrow), blood vessels and multinucleated giant cells (red arrow) (×40).

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A combination of intralesional injection of corticosteroids [injection triamcinolone acetonide (Kenocort)] 10 mg/ml twice a week for three weeks was started, along with tablet minocycline (OD) 100 mg for three weeks. Post-treatment follow up after three weeks showed complete resolution of swelling without recurrence [Figure 3].
Figure 3: Post-treatment follow up at the end of third week (arrows).

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Conflicts of Interest: None.


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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