In the previous post, we questioned the complementary examination to ask for.

Initial situation :

A young man, aged 18, is referred to the oral dermatology consultation Henri Mondor Hospital because of a 2 months persistent lower macrocheilia. The patient has no medical history and takes no MEDICATION. The medical examination reported severe stress episode related to the bachelor degree associated with digestive disorders: diarrhea and constipation. The endo-oral examination revealed : several linear ulcerations of the oral vestibule and nodules in both labial commissure and adjacent buccal mucosa. The tongue has a normal clinical aspect, as the palpation of the tumefied lower lip is painless.

Complementary examination to ask for

Lip Biopsy and Anatomopathological examination

Lip biopsy and anatomopathological examination reveals : « Epithelioid granulomas. Giant cells with noncaseating granulomas. »

Orofacial granulomatosis diagnostic hypothesis is settled.