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Cheilitis Granulomatosa of Miescher vs the Melkersson-Rosenthal Syndrome. Presented by Donald R. Shasky, MD.
A 39-year-old, white secretary, born in Louisiana, has had recurrent swelling of the uvula and the upper lip since her last pregnancy which was terminated a little more than two years ago. She can predict an occurrence, which comes approximately every four to six weeks, by increased irritability and fatigue. She has previously been treated with dexamethasone (Decadron) injections, oral steroids, and diphenhydramine (Benadryl), which helped during the acute stages; however, the swelling never completely goes away. She has changed toothpaste, eliminated several foods, and used nonallergenic cosmetics without any appreciable benefit.All her children have allergies, and most of them have hayfever.
Examination.—
The uvula is swollen about twice its normal size and the upper lip is markedly edematous and firm. There are no lingua plicata. Plaques of xanthelasmas of the lower eyelids are