[Crohn disease--initial manifestation in the oral and anogenital area]

A case is reported of Crohn's disease in a 17-year-old patient. The initial manifestation was bipolar: the clinical features of macrocheilitis with swelling of the upper lip that had persisted for the last 6 months. The buccal tissue disclosed a cobblestone-appearance, combined with atypical fissures and rhagades in the anogenital region. Histopathological examination of lip and anogenital biopsy specimens revealed a granulomatous inflammatory reaction. Therefore, the clinical findings were interpreted as the primary manifestation of Crohn's disease. In the differential diagnosis Melkersson-Rosenthal's syndrome was also taken into consideration.