02267nas a2200373   4500000000100000008004100001260001300042653001500055653001000070653001400080653001000094653002000104653001100124653001400135653001100149653001200160653001700172653001800189653002600207653000900233653001600242653004100258653002600299653001700325100001200342700001500354700001600369700001200385245007100397300001100468490000700479520139300486022001401879       2003                            d  c2003 May10aAdolescent10aAdult10aCheilitis10aChild10aChronic Disease10aFemale10aGranuloma10aHumans10aleprosy10aLip Diseases10aLip Neoplasms10aLymphoma, Non-Hodgkin10aMale10aMiddle Aged10aMultiple Endocrine Neoplasia Type 2b10aRetrospective Studies10aTuberculosis1 aHanda S1 aSaraswat A1 aRadotra B D1 aKumar B00aChronic macrocheilia: a clinico-pathological study of 28 patients.  a245-500 v283 a<p>Chronic macrocheilia has a multifactorial aetiology and is often a diagnostic and therapeutic challenge. Epidemiological information on this condition is scarce, most of the data reported relating only to granulomatous cheilitis. We have performed a detailed clinico-pathological analysis of all patients with chronic macrocheilia presenting to us during the last 6.5 years. Of the 28 patients identified, 13 (46.4%) had granulomatous cheilitis (GC), six (21.4%) had tuberculosis of the lip, three (10.7%) had leprous macrocheilia, two (7.1%) had multiple endocrine neoplasia type IIb, and one each had Ascher's syndrome and non-Hodgkin's lymphoma. Two patients were diagnosed as 'nonspecific cheilitis'. Histopathological differentiation between tuberculosis and GC was often not possible; but PCR for Mycobacterium tuberculosis was positive in all patients with tuberculosis and negative in four patients with GC in whom M. tuberculosis was sought. In spite of detailed clinical examination and investigations, a therapeutic trial was required to confirm the diagnosis in five (17.9%) patients. We have reviewed the available literature on this subject, and to our knowledge this study is the first of its kind. More such studies from other centres will help physicians to make an accurate aetiological diagnosis and treat this uncommon but disfiguring condition with confidence.</p>  a0307-6938