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Oral pathology

Diet-controlled orofacial granulomatosis in a child

British Dental Journal volume 239, pages 555–556 (2025)Cite this article

Orofacial granulomatosis (OFG) is a rare inflammatory condition affecting the lips, facial tissues, and oral mucosa, often presenting diagnostic and therapeutic challenges, particularly in paediatric patients. This case report describes a four-year-old boy with persistent upper lip swelling, diagnosed clinically with OFG after exclusion of systemic granulomatous conditions, including Crohn's disease. Management was initiated with a cinnamon- and benzoate-free diet, resulting in complete resolution of symptoms within three months. Endoscopic and histopathological findings excluded gastrointestinal involvement. Long-term management involved continued dietary modifications, supported by a diet diary to identify and avoid triggers. This case highlights the value of dietary interventions as a first-line management strategy for paediatric OFG, providing a non-invasive alternative to pharmacological therapies. The findings emphasise the importance of early recognition and multidisciplinary collaboration in managing OFG in children.

A four-year-old boy was referred to the University Dental Hospital of Manchester with a one-year history of persistent upper lip swelling. His medical history was unremarkable, with no reported weight loss or abdominal pain. However, the parents described intermittent episodes of constipation and bloody stools. Family history included a paternal cousin diagnosed with Crohn's disease.

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References

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  2. Joshi S, Mawdsley J, Hullah E, Ormond O, Carey B. Management of orofacial granulomatosis. Br J Hosp Med (Lond) 2023; 84: 1–16.

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Authors and Affiliations

  1. The University of Manchester, Manchester, United Kingdom

    S. Acharya & M. Dave

  2. The University of Manchester, Manchester, UK; The University Dental Hospital of Manchester, Manchester, United Kingdom

    S. Barry

  3. The University Dental Hospital of Manchester, Manchester, United Kingdom

    M. Rudralingam

Authors
  1. S. Acharya
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  2. M. Dave
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  3. S. Barry
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  4. M. Rudralingam
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Correspondence to S. Acharya, M. Dave, S. Barry or M. Rudralingam.

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Acharya, S., Dave, M., Barry, S. et al. Diet-controlled orofacial granulomatosis in a child. Br Dent J 239, 555–556 (2025). https://doi.org/10.1038/s41415-025-9308-9

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  • DOI: https://doi.org/10.1038/s41415-025-9308-9

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