Oro-facial granulomatosis: a possible allergic basis

Food or flavouring intolerance has been demonstrated in 14 out of 80 patients with oro-facial granulomatosis. Provoking molecules include cinnamaldehyde, carvone and piperitone, although a wide range of food or flavourings may be implicated. The nature of the reaction is not understood but does not seem to involve an IgE mediated response. At present the only reliable way of detecting specific provoking factors is by the use of an elimination diet.