What is the most effective treatment of cheilitis granulomatosa in Melkersson-Rosenthal syndrome?

摘要

Editor,The treatment of cheilitis granulomatosa (CG) in Melkersson-Rosenthal syndrome (MRS) remains a challenge because of the unclear aetiopathogenesis. Various therapeutic methods were described. There are no randomized, placebo-controlled trials and therefore it is difficult to compare them. Corticosteroids are widely used; some authors recommend systemic corticosteroids in CG therapy, while others did not observe success with systemic methylprednisone therapy. In our opinion, long-term systemic corticosteroid usage is connected with the high risk of side-effects, and so it should not be the first line of treatment. Topical triam-cinolone or clobetasol in orobase may cause atrophy; intralesional administration of triamcinolone remains favourable, but the response is temporary. Because of this reason, other non-steroidal anti-inflammatory agents are used. A very interesting alternative is clofazimine. Sussman et al. showed complete remission in five of the 11 patients with CG following the treatment. Ratzinger et al.5 observed complete or partial response in majority of patients treated with clofazimine.