Orofacial Granulomatosis Crohn — ORE Part 1 MCQ
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Correct answer: B — Orofacial granulomatosis
The clinical and histopathological presentation—chronic lip swelling, oral ulceration, and non-caseating granulomas on biopsy—in the context of Crohn's disease defines orofacial granulomatosis (OFG). OFG is an umbrella diagnosis encompassing granulomatous inflammation of oral and facial tissues; it includes both idiopathic cases and oral manifestations of systemic conditions such as Crohn's disease and sarcoidosis. Melkersson-Rosenthal syndrome (option D) is a recognised clinical subtype of OFG characterised by the triad of recurrent lip swelling, oral ulceration, and facial nerve paralysis; however, it is not the primary overarching diagnostic term and is subsumed within OFG. Angioedema and allergic reactions do not produce granulomatous inflammation on histology. Sarcoidosis is a differential diagnosis when non-caseating granulomas are found, but the stem establishes Crohn's disease as the underlying diagnosis.
Reference: Leão JC, Hodgson T, Scully C. Review article: orofacial granulomatosis. Aliment Pharmacol Ther. 2004;20(10):1019–1027; https://pubmed.ncbi.nlm.nih.gov/15569103/