Cheilitis Granulomatosa

Key Points
Uncommon skin condition affecting the lips
Can be brought on by various conditions, such as allergies, Crohn Disease and Sarcoidosis
Consists of a lumpy-feeling swelling of the lips

Granulomatous cheilitis is an uncommon skin condition which affects the lips, and sometimes the face. It consists of a lumpy-feeling swelling of the lips, and in some cases other areas of the face. Swelling begins in the upper lip, which may resolve quickly. Affected areas will feel nodular and be soft or firm to the touch. In some cases, both lips may swell, and rarely, the forehead, eyelids or even the scalp may experience swelling. Granulomatous cheilitis may be accompanied by fever, headache, lymph node enlargement, Fissured tongue, and weakness of the facial muscles.

Granulomatous cheilitis occurs in conjunction with other conditions, such as allergies, Crohn Disease, and Sarcoidosis. In rare cases, it can occur with genetic disorders, cancers, and infections. Overall, the condition is rare and may affect any gender, age or ethnic group, and generally appears during early adulthood.

Differential Diagnosis (Other conditions with similar appearance)

Angioedema, Acquired
Lymphoma
Angioedema, Hereditary
Rhinosporidiosis
Crohn Disease
Sarcoidosis
Leprosy
Tuberculosis

Diagnosis
Key Points
Initial diagnosis based on skin appearance
Skin Biopsy will be performed to confirm diagnosis and rule out other similar appearing conditions

Granulomatous cheilitis is initially diagnosed based on the appearance of the affected area. Health care professionals will then perform a biopsy of the affected area to confirm the diagnosis and rule out the presence of other, similar appearing conditions.

Treatment
Treatment often predicated on the associated condition
Goal of treatment is to reduce or eliminate symptoms
In some cases, treatment of the associated condition may reduce symptoms

Treatment of granulomatous cheilitis is often predicated on the treatment of the associated condition. In granulomatous cheilitis caused by an allergy, it is recommended that the allergen be avoided. Additionally, treatment of other associated conditions may reduce symptoms. Several therapies have been shown to have varying effects, including topical corticosteroids, long-term antibiotic/anti-inflammatory drug courses, corticosteroid Injections to the affected area, mast cell stabilizers, Sulfasalazine, Clofazimine, and even surgical reduction of the affected area.