BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b849 (Published 02 March 2009) Cite this as: BMJ 2009;338:b849
  1. Katherine Catford, paediatric specialist registrar,
  2. Vas Mahendrayogam, foundation year 1,
  3. Ramen Lakshman, consultant paediatrician
  1. 1West Suffolk Hospital, Bury St Edmunds, Suffolk IP33 2QZ
  1. katcatford{at}yahoo.co.uk

    This otherwise healthy 8 year old boy was referred with persistent swelling of his upper lip. The diagnosis was orofacial granulomatosis, a chronic non-caseating granulomatous inflammation that usually affects the upper lip. The natural history is of a fluctuating condition with some evidence of aggravation by food additives, and dietary exclusions (of sodium benzoate) may be tried as a treatment. Most importantly, this condition can be a presentation of Crohn’s disease; initial investigations and regular follow-up should be arranged with this in mind.


    Cite this as: BMJ 2009;338:b849


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