Melkersson Rosenthal Syndrome
In this al tutorial we will discuss a caseof MelkerssonRosenthal Syndrome Lets start with our case.12 year old boy weighing 23.5 kilos presented with complaint of fissured tongue for last one and a half year, Lip swelling for last four day and fever for last 2 day. There is no problem with taste sensation.Patient complain of tingling and burning sensation while taking salty and spicy food Observe furrowed tongue in this boy. Furrowed tongue is also known as scrotal tongue. Observe lip swelling in this boy Lower lip is more swollen as compared to upper lip.
Based on presenting complaint and examination findings a provisional diagnosis of MelkerssonRosenthal Syndrome was made. .and patient was put on paracetamol for fever and was asked to come for follow up after 23 days MelkerssonRosenthal Syndrome is a triad of 1.Facial Lip Swelling 2.Furrowed Tongue and Recurrent Facial Paralysis. It should be noted over here is that complete triad is unusual to find.Facial swelling is most common which is usually asymmetrical and is absent here. .followed by edema of Lips followed by furrowing of tongue and facial palsy which is also absent in our case Lip swelling and furrowed tongue are sufficient findings to make a diagnosis of MelkerssonRosenthal Syndrome. There is no erythema or pain in tongue or lips,no itching on swollen lip. When patient came for followup after 3 days,lid swelling on right side has appeared and lip swelling has increased.
Just observe carefully. The cause of this condition is unknown. Reassurance is all that is needed as attack usually disappear within days or week. But if facial and lip swelling are bothering patient,systemic corticosteroids should be administered. Finally Crohn's Disease and Mycobacterial Infections have to be ruled out in these patients.