Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report

Melkersson-Rosenthal syndrome (MRS) is a rare neuro-mucocutaneous disorder characterized by recurrent orofacial edema, peripheral facial palsy and a fissured tongue, although the complete triad is rarely observed. The present study reports the case of a 22-year-old male patient who initially presented with facial paralysis, later developing cheek edema, dermatosis and systemic symptoms; the histopathological findings consistent with granulomatous cheilitis. Laboratory analyses revealed a low C1q level and positive antinuclear antibody. Based on clinical and biopsy findings, MRS was diagnosed. The patient responded well to a 6-month regimen of deflazacort, epinastine and methotrexate. On the whole, the present case report illustrates an incomplete, yet clinically significant form of MRS. Diagnosis is primarily clinical, supported by histology and exclusion of similar conditions. Treatment focuses on symptom control with corticosteroids; immunomodulators or biologics may be used in refractory cases. Early recognition is essential, even in the absence of the full triad.