OFG

Question 1

OFG vs angio-oedema?

Answer 1

AO
- oedema of oral and facial soft tissues due to increase in fluid exudate from capillaries but with no lymphatic drainage obstruction

OFG
- no increase in exudate of fluid from capillaries
- obstruction to lymphatic drainage allowing fluid to accumulate within soft tissues

AO settles fast, OFG settles slowly

Question 2

Histology of OFG vs AO

Answer 2

AO
- tissue swelling in connective tissue

OFG
- giant cell multinucleated granulomas within the tissue
- obstructing lymphatics

Question 3

What type of hypersensitivity reaction is AO and OFG?

Answer 3

AO
- 1

OFG
- 3

Question 4

Histological markers of OFG?

Answer 4

Granulomatomous infiltration and mild oedema

Prescience of giant cells that are multinucleated

Question 5

Histological markers of Angio oedema?

Answer 5

Oedema

Leukocyte infiltration

Absence of epidermal changes

Sometimes mast cell degranulation

Question 6

What must be ruled out when OFG / AO is suspected?

Answer 6

Sarcoidosis

Tuberculosis

Crohns

Ulcerative colitis

Question 7

Give epidemiology of OFG

Answer 7

Can present at any age but common in later childhood / adolescents

Often low level presentation and mild

Question 8

If patient presents with OFG, what is important to ask about general health?

Answer 8

Any abdominal pain or altered bowel habit? Could possibly be a crohns issue

Question 9

Management of OFG?

Answer 9

Consider GI symptoms of crohns
- sequential growth monitoring

3 month dietary exclusion of things like benzoate or cinnamon

Topical tx for angular chelitis
- miconazole

Topical tx to lip or facial erythema
- tacrolimus ointment 0.03%

Question 10

What foods often trigger OFG?

Answer 10

Bernzoic acid

Sorbic acid

Cinnamon products

Chocolate