A Case of Persistent Oral Mucosal Ulcerative Lesion in a Pediatric Patient

Orofacial granulomatosis (OFG) is characterized by non-caseating granulomatous inflammation microscopically and clinically presents with persistent soft tissue swelling of the oral and maxillofacial regions. However, OFG can be challenging to diagnose when presenting with atypical and less common clinical features. We present a case of an eleven-year-old male child with a persistent lower lip ulcerative lesion for 3-4 months which was earlier labelled as major aphthous ulcer with no response to subsequent therapies. Histopathologic examination confirmed the diagnosis of OFG. Treatment with intralesional corticosteroids (triamcinolone acetonide, 5 mg/ml) led to rapid improvement. This case highlights the diagnostic and therapeutic challenges of managing uncommon forms of OFG in paediatric patients.