18例肉芽肿性唇炎临床与病理特点分析

Clinical and pathological analysis of granulomatous cheilitis： 18 case reports

目的探讨肉芽肿性唇炎临床表现与组织病理学特点。方法回顾分析2010—2014年18例肉芽肿性唇炎患者临床及病理学资料。结果肉芽肿性唇炎患者18例中，男9例，女9例，确诊时患者年龄38～77岁，平均（55．2±11.2）岁；病程5～96个月，平均（20．5±22．7）个月；病程〈1年11例，〉1年7例。18例患者均出现唇部复发性肿胀，皮疹触之有软橡皮感，无压痛。组织病理符合非干酪性坏死上皮细胞肉芽肿14例，非特异性炎症4例。1例拔除龋齿后皮损消退，9例患者使用泼尼松或加用羟氯喹治疗，其中6例皮损消退，3例疗效不佳。结论肉芽肿性唇炎是一种不伴有其他体征或症状的独立口面肉芽肿疾病，需要临床结合组织病理检查进行诊断。

Objective To assess the clinical and histopathologic characteristics of granulomatous cheilitis. Methods Clinical and pathological data were collected from 18 patients with granulomatous cheilitis between 2010 and 2014, and analyzed retrospectively. Results Of the 18 patients, 9 were male and 9 were female. The age at final diagnosis ranged from 38 to 77 years （mean, 55.2 ± 11.2 years）. The clinical course was less than 1 year in 11 patients, more than 1 year in 7 patients, and varied from 5 to 96 months （mean, 20.5 ± 22.7 months）. All the patients presented with recurrent painless swelling of the lips, which were rubbery on palpation. Histopathological findings were consistent with non-caseous necrotic epithelioid cell granuloma in 14 cases, and with nonspecific inflammation in 4 cases. Skin lesions subsided in 1 patient after the removal of a decayed tooth. Of the 9 patients treated with oral prednisone alone or in combination with hydroxychloroquine, 6 experienced subsidence of lesions, but 3 poorly responded. Conclusion Granulomatous cheilitis is an independent orofacial granulomatous disease without accompanying signs or symptoms, and its diagnosis should be based on clinical and pathological presentations.