MELKERSSON-ROSENTHAL SYNDROME

By Gary M. White, MD

Melkersson-Rosenthal Syndrome


The Melkersson-Rosenthal Syndrome classically is the triad of swollen lips, facial palsy and a scrotal tongue.

Clinical

One or both lips suddenly become enlarged. Over time, this enlargement may become permanent. The tongue may be heavily fissured (scrotal tongue). There may be associated facial palsy. Biopsy of the lip showing granulomatous changes may be necessary for diagnosis. The presence of Crohn's disease and allergic contact dermatitis to foods (e.g., chocolate) should be excluded.

Treatment

High volume intralesional triamcinolone (3-10 mg/cc) after nerve block anesthesia has been recommended. Lip reduction surgery has been performed.

Combining IL therapy with oral antiinflamatory agents is often employed. Reportedly helpful medications include doxycycline/minocycline (must be over age 8), prednisone (0.6-1.0 mg/kg/day), thalidomide [AD 2003;139;136], dapsone, sulfasalazine, hydroxychhloroquine, clofazamine, and anti-TNF agents.

Additional Pictures

Courtesy Michael O. Murphy, MD
Melkersson-Rosenthal Syndrome

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