1/6. Childhood granulomatous periorificial dermatitis: a controversial disease. The etiology, diagnosis and treatment of childhood granulomatous periorificial dermatitis (GPD) are highly controversial. Some authors underline the similarities between GPD and perioral dermatitis and consider both as part of a spectrum while other authors regard GPD as a distinctive condition. Clinically GPD is a papulo-pustular periorificial disease of the face which histopathologically shows a granulomatous perifollicular infiltrate. Because of its granulomatous pattern, GPD also has been related to cutaneous sarcoidosis. The clinical course is benign and self-limited. Topical steroids are regarded as either the main cause or a worsening factor. While topical treatment is occasionally effective, systemic antibiotic therapy of GPD is usually recommended. We report a "typical" case of GPD and review the literature to discuss the difficulties in its diagnosis and treatment. ( info) |
| Orofacial granulomatosis comprises a group of diseases characterized by noncaseating granulomatous inflammation affecting the soft tissues of the oral and maxillofacial region. The most common clinical presentation is persistent swelling of one or both lips. It is important to establish the diagnosis accurately because this condition is sometimes a manifestation of Crohn's disease or sarcoidosis. This article describes 2 cases of orofacial granulomatosis, in one of which the condition was a manifestation of Crohn"s disease. The diagnostic approach to and the treatment of orofacial granulomatosis are reviewed. ( info) |
3/6. Granulomatous cutaneous centrofacial and meningocerebral amebiasis. A 7-year-old, otherwise healthy Peruvian boy presented with a 3-month history of an indurated centrofacial plaque. Histologic examination revealed a granuloma containing free-living amebae tentatively identified as balamuthia mandrillaris. The patient failed to respond to tentative treatment. He was admitted to the intensive care unit 7 months later with neurologic manifestations of granulomatous amebic encephalitis, which proved fatal. The difficulty in diagnosing this rare presentation of cutaneous amebiasis, the challenge of treating the condition, and the morbidity and high mortality associated with cerebral involvement are discussed. ( info) |
4/6. Epulis granulomatosa as an oral manifestation of Klippel-Trenaunay syndrome. The Klippel-Trenaunay syndrome (KTS) was first described by Klippel and Trenaunay in 1900. It is characterized by the triad of hemihypertrophy of soft and hard tissue, naevus flammeus and venous varicosity in the affected area. Though all oral tissues may be affected, only 5% of KTS show manifestations in the head and neck region. Only three cases are described with an oral manifestation, showing gingival overgrowth clinically and histologically corresponding to a pyogenic granuloma. It is still uncertain whether the combination of gingival fibromatosis and KTS is significant or coincidental. We report about a 25-year-old patient with KTS and recidivous gingival fibromatosis, clinically and histologically corresponding to an epulis fibromatosa in a case report. It is suggested that this occurrence is significant. ( info) |
5/6. nasal septum perforation: rare manifestation of Crohn's disease. We report a 25-year-old man with four-year history of weight loss, diarrhea and intermittent epistaxis. endoscopy and biopsy showed inflammation of the nasal mucosa. Endoscopic and histologic diagnosis of Crohn s disease was made later; the granulomatous nasal lesions responded to sulfasalazine and azathioprine. ( info) |
6/6. Case of childhood granulomatous periorificial dermatitis in a Korean boy treated by oral erythromycin. Childhood granulomatous periorificial dermatitis (CGPD) is a disease presenting most commonly in prepubertal children as yellow-brown papules limited to the perioral, perinasal and periocular regions. The condition is benign, self-limiting and is not associated with systemic involvement. We herein report a case of an 11-year-old Korean boy with multiple, asymptomatic, monomorphic, red-to-yellow-colored papular eruptions on the perioral areas of 7-month duration. Histopathological examination revealed upper dermal and perifollicular granulomatous infiltrate. After using oral erythromycin 500 mg daily for 1 year, the condition resolved completely without leaving a scar. ( info) |