Granulomatous cheilitis with intralymphatic histiocytosis possibly associated with calcium deposition caused by chronic inflammation owing to dental metals and periodontitis

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Abstract

Granulomatous cheilitis (GC) is an uncommon disease and the pathogenesis of GC has not been clear. Here, we present two cases of GC associated with calcium deposition caused by chronic inflammation owing to dental metal allergy and periodontitis. Histopathologically, intralymphatic histiocytosis (IH) in addition to non-caseating granulomas was seen in both cases. The results of a patch test were positive for some dental metals. Qualitative analyses by energy-dispersive X-ray spectroscopy detected calcium from biopsy specimens. We considered that partial destruction of teeth by chronic inflammation induced reactive proliferation of histiocytes, resulting in IH. Our study suggests that GC and IH is a consequence of chronic inflammatory diseases caused by dental metals and periodontitis. Dental care is necessary for treatment of GC.

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