Question 61

Question 1

eplain OFG and clinical features

Answer 1

• Chronic inflammatory disorder, average age of onset = 11 y/o
• Identical appearance to oral manifestation of crohn’s disease and may be a predictor
• Non-caseating giant cell granulomas result in lymphatic obstruction
• Clinical features – lip swelling, full thickness gingival swelling, peri-oral erythema, cobblestoning of buccal mucosa, linear oral ulceration, mucosal tags, lip/tongue fissuring, angular cheilitis

Question 2

diagnosis for OFG

Answer 2

o Identify Crohn’s – measure growth, faecal calprotectin, endoscopy
 Ask patient if they’ve had any bowel problems?
o FBC, haematinics – deficiency
o Diet diary, patch testing – identify allergens

Question 3

Treatment OFG

Answer 3

o Referral to OM and paeds
o Support with OH
o Symptomatic relief as per oral ulceration – difflam MW and LA sprays
o Dietary exclusion – cinnamon, benzoates, chocolate
o Topical steroids, tacrolimus
o Surgery