What are the other Names for this Condition? (Also known as/Synonyms)

• Cheilitis Granulomatosa
• Miescher Cheilitis

What is Granulomatous Cheilitis? (Definition/Background Information)

• Granulomatous Cheilitis, or Cheilitis Granulomatosa, is a rare lip condition of unknown cause that is generally observed in young adults. It is a persistent condition that is marked by the presence of non-tender swelling of a single lip or both lips
• Granulomatous Cheilitis may form part of other conditions, notably orofacial granulomatosis. In such cases, apart from swollen lips, other signs and symptoms of the associated condition may be noted

Who gets Granulomatous Cheilitis? (Age and Sex Distribution)

• Granulomatous Cheilitis is mostly observed in young adults, but it may affect individuals of any age range, including children
• Both males and females are affected
• Worldwide, there is no racial or ethnic preference observed. However, Granulomatous Cheilitis is a very rare condition

What are the Risk Factors for Granulomatous Cheilitis? (Predisposing Factors)

Granulomatous Cheilitis is associated with the following conditions/factors:

• Allergic contact dermatitis
• Crohn disease
• Orofacial granulomatosis
• Sarcoidosis
• Genetic disorders
• Any condition, such as an infection or cancer, which causes an obstruction of lymphatics of the lips

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Granulomatous Cheilitis? (Etiology)

The exact cause of development of Granulomatous Cheilitis is presently not well-understood. It is believed to be immune-mediated and may form a part of other conditions and disorders.

What are the Signs and Symptoms of Granulomatous Cheilitis?

The signs and symptoms of Granulomatous Cheilitis may vary from one individual to another. It may also depend on the underlying/associated condition. These may include:

• Swollen lip that has a sudden onset
• One or both lips may be involved
• The swelling may be described as hard and non-tender
• This may subside within a few hours to days, to return again
• Recurrent attacks may be even more severe
• The swollen lips may crack, bleed, and ulcerate
• Scaly lips that are red-brown in color may be noted
• The size of the lips may keep increasing to eventually become like a hard rubber

Other systemic signs and symptoms, such as fever, lymph node enlargement, fissured tongue, and facial palsy, may be noted based on the associated condition.

How is Granulomatous Cheilitis Diagnosed?

A diagnosis of Granulomatous Cheilitis may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation
• Assessment of presenting signs and symptoms
• Skin tissue biopsy of lip: A tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Additional tests and examinations to diagnose the underlying/associated condition, if any, may be necessary.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Granulomatous Cheilitis?

The possible complications due to Granulomatous Cheilitis include:

• Emotional stress from cosmetic concerns
• Superimposed bacterial and fungal skin infections is mostly noted with untreated cases
• Persistent and recurrent condition
• Treatment complications and side effects

Complications from the underlying/associated condition may be observed.

• Granulomatous Cheilitis can be associated with Crohn disease, scrotal tongue, or 7^th cranial nerve palsy
• Granulomatous Cheilitis is also a part of Melkersson-Rosenthal syndrome, with recurring facial paralysis, swelling of face and lips, and scrotal tongue
• An association with sarcoidosis is also sometimes noted

How is Granulomatous Cheilitis Treated?

The healthcare provider may recommend the following treatment measures for Granulomatous Cheilitis:

• Appropriate treatment of the underlying/associated condition, if noted
• Topical or intralesional corticosteroid therapy may be recommended along-with antibiotic therapy
• Administration of non-steroidal anti-inflammatory drugs (NSAIDs)
• Antibiotic or antifungal therapy for secondary infections
• Administration of mast cell stabilizers
• Surgical procedures for treating the affected lip, as determined by the healthcare provider. A typical procedure considered may be a cheiloplasty after the cheilitis is controlled

Regular follow up visits with the healthcare provider is important and recommended.

How can Granulomatous Cheilitis be Prevented?

• Presently, it is not possible to prevent Granulomatous Cheilitis since the cause of the condition is unknown
• Considering early and adequate treatment of the underlying/associated condition may help in minimizing the risk for Granulomatous Cheilitis

What is the Prognosis of Granulomatous Cheilitis? (Outcomes/Resolutions)

• The prognosis of Granulomatous Cheilitis depends on the severity of underlying/associated condition
• In many individuals, with prompt and appropriate therapy, the prognosis may be good

Additional and Relevant Useful Information for Granulomatous Cheilitis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/