MIESCHERS CHEILITIS: A CASE REPORT AND LITERATURE REVIEW

Introduction:Miescher’s cheilitis is an unusual chronic inflammatory condition, which typically presents with episodic, painless swelling of the lips. It is group of orofacial granulomatosis and may appear as isolated or part of Melkersson-Rosenthal syndrome. The aetiology is unknown, but proposed theories include genetic predisposition, immune dysfunction, allergies and infections. Case Presentation:Herein, we describe a 54-year-old female patient who developed slowly progressive non-tender upper lip swelling, without any evidence of fever or systemic features. McMeel's examination findings were consistent with idiopathic macrocheilitis. Inflammatory parameters in routineblood work were only mildly increased with normal results of immunologic assays and imaging. A lip biopsy revealed non-caseating granulomatous inflammation with epithelioid histiocytes and multinucleated giant cells, compatible with a diagnosis of Miescher’s cheilitis. The patient had an excellent response to systemic corticosteroids and repeated attacks were managed by repeated short courses of oral corticosteroids and intralesional corticosteroid injections. Conclusion:This case underscores the diagnosis and management of Miescher’s cheilitis is difficult because of the lack of specific presentation and the chronic relapsing nature of the condition. Histologic evaluation continues to be the cornerstone tool for diagnosis and corticosteroids are considered as the standard of treatment. Continual clinic follow-up is needed to evaluate the activity of the disease, and assess control of any recurrences and modify therapeutic approach if necessary.