Melkersson-Rosenthal syndrome

Melkersson-Rosenthal syndrome (Ie, Melkersson, S. Rosenthal) - a combination of swelling separate parts of the face, most often lips with peripheral paresis of the facial nerve and folded language. In 1928 Melkersson on the basis of "angioneuroticeski swelling of the lips and recurrent facial nerve paresis have identified the disease in a separate nosological form. Rosenthal has supplemented its third symptom - folding language. The Miescher (C. Miescher) from a large group of "essential inflammatory macrorelief" allocated granulomatous cheilitis with a characteristic clinical and histological pattern. Along with a chronic illness leading to mikrogelei, he stressed the lack of visible inflammatory changes in this disease.
Swelling of the lips may occur simultaneously with the recurrence of paralysis of the facial nerve, but often the latter appears much later. The swelling usually appears on the lips, cheeks and tongue and mucous membranes of the oral cavity, pharynx, nose and other parts of the body. She has sharply expressed inflammatory nature, painless, as a rule, the color of the skin and mucous membranes has not changed. Swollen tissue solid elastic consistence, the lip can be increased in 3-4 times (Fig.). Unlike angioedema swelling persistent and is not accompanied by eosinophilia of blood. Swollen lips habitablezone thickened and protruding. When swelling just face it reminds "the lion's mask". Folded language as constitutionally attribute is observed only in half of the cases, paresis of the facial nerve - about a third of cases. In addition to peripheral paralysis of the facial nerve, possible brain and spinal cord, the number of cranial nerves.
Melkersson-Rosenthal syndrome is considered polietiologic disease. Pathogenetic basis of the syndrome are angioneuroticeski violations and inflammatory granulomatous changes; given the importance of infectious allergies.
Treatment. Combined use of prednisone on 15-20 mg / day, Raskina (or its analogues) 0.25 g 2 times a day and oxytetracycline on 300-400-600 ED day (or other broad-spectrum antibiotic) gives the best results. In some cases it is recommended wedge-shaped excision of the entire thickness of the affected lips.