Intralesional injection of Pingyangmycin plus corticosteroids may be an effective treatment for cheilitis granulomatosa

Abstract

Cheilitis granulomatosa is a rare disease characterised by the recurrent labial swelling of one or both lips with the possibility of the condition to remain on a permanent basis. This kind of granulomatous, inflammatory disease may appear independently or be linked to a paralysis such as the facial and lingua plicata which then characteristic of the Melkersson–Rosenthal syndrome. Classically, a non-necrotizing granulomatous inflammation is seen at histologic examination. Many treatments have been tried. But as its high recurrence rate, the results were often disappointing. The major active component of Pingyangmycin is bleomycin A5. Currently, bleomycin has been proved to be a widely accepted treatment protocol for hemangiomas and lymphangioma. It has been proved that bleomycin could infiltrate prominently into lymphocytes and other inflammatory cells. Stromal connective tissue would proliferate markedly as the result of sclerotherapy. Oedema, lymphangiectasia and perivascular lymphocytic infiltration are always seen in cheilitis granulomatosa histologically. Therefore, we hypothesize that intralesional injection of Pingyangmycin plus corticosteroids may be a safe and effective treatment for cheilitis granulomatosa. The efficacy of this treatment modality is worthy of further investigation.