Miescher's Granulomatous Cheilitis: A Rare Cause of Recurrent Lip Inflammation

Miescher's granulomatous cheilitis (GC) is a rare, noninfectious, chronic, idiopathic granulomatous disorder characterized by recurrent swelling of the lips. It is considered part of the triad of Melkersson-Rosenthal syndrome, a neurological and cutaneous disorder characterized by orofacial edema, peripheral facial nerve palsy, and a fissured tongue. However, the complete triad is uncommon, and Miescher's GC may present as a monosymptomatic form. Due to its rarity, the condition has a broad differential diagnosis and poses a diagnostic challenge. We report the case of a 33-year-old woman with no relevant medical history who presented with chronic, recurrent swelling of the lower lip. She was initially treated for a presumed allergic reaction with antihistamines, without improvement. A lip biopsy was performed, revealing histopathological findings consistent with GC. The patient was treated with prednisone and doxycycline, followed by intralesional methylprednisolone injections, resulting in a favorable clinical response without recurrence. This case highlights the importance of recognizing localized orofacial manifestations and providing timely, individualized treatment to reduce the risk of recurrence.