*3.1.4 Orofacial granulomatosis*

The term orofacial granulomatosis (OFG) includes a group of disorders showing chronic, noncaseating granulomatous lesions involving the perioral tissue of the face and oral mucosa [79]. Possible systemic diseases, such as tuberculosis, sarcoidosis, and other diseases with the same clinical findings are to be excluded before to diagnose orofacial granuloma [80]. Clinically, OFG generally presents as swelling of upper and/lower lip, even the whole orofacial region including the chin, cheeks, periorbital and zygomatic tissues, eyelids, and forehead, unilaterally or bilaterally, either alone or in combination, though classic presentation is that of a non-tender recurrent labial swelling that may eventually become persistent [79] (**Figure 15**). Furthermore, manifestations include angular cheilitis, mucosal ulcerations, vertical fissures of the lips, mucosal tags, and lingua plicata [81]. However, the clinical

**Figure 14.** *Metastatic Crohn's disease.*

**Figure 15.** *Orofacial Granulomatosis.*

presentation can be highly variable, making the diagnosis difficult to establish, i.e., intraoral involvement may take the form of hypertrophy, erythema, or nonspecific erosions involving the gingiva, oral mucosa, or tongue [80–82]. Clinicopathological correlation is required for final diagnosis.
