Oligosymptomatic form of Melkersson-Rosenthal Syndrome possibly triggered by Covid-19 infection: a case report

Nisada Đuzelić; Nina Čamdžić; Dževad Durmišević; Amir Rekić; Selma Hodžić; Asja Prohić

doi:10.2478/amma-2024-0004

Nisada Đuzelić Cantonal Hospital “Dr. Irfan Ljubijankić”, Department of Dermatovenerology, 77000 Bihać, Bosnia and Herzegovina
Nina Čamdžić Department of Pathology, Faculty of Medicine University of Sarajevo
Dževad Durmišević Cantonal Hospital “Dr. Irfan Ljubijankić”, Department of Pathology, 77000 Bihać, Bosnia and Herzegovina
Amir Rekić Cantonal Hospital “Dr. Irfan Ljubijankić”, Department for ear, nose and throat diseases, 77000 Bihać, Bosnia and Herzegovina
Selma Hodžić Cantonal Hospital “Dr. Irfan Ljubijankić”, Department for ear, nose and throat diseases, 77000 Bihać, Bosnia and Herzegovina
Asja Prohić Department of Dermatovenerology, Sarajevo Medical School, University of Sarajevo School of Science and Technology, 71000 Sarajevo, Bosnia and Herzegovina

DOI: https://doi.org/10.2478/amma-2024-0004

Keywords: Melkersson-Rosenthal syndrome, granulomatous cheilitis, COVID-19, oligosymptomatic

Abstract

Introduction: Melkersson Rosenthal syndrome (MRS) is a disease of multifactorial origin typically presented with a triad of symptoms including peripheral facial nerve paralysis, plicated tongue and orofacial edema. Diagnosing MRS requires the exclusion of other granulomatous diseases and the correlation of clinical with histopathological finding.

Case presentation: We present the case of a 56-year-old female with a four-month history of lower lip and right mandible angle swelling together with a plicated tongue that appeared during COVID-19 infection. The patient was successfully treated with intralesional Triamcinolone Acetonide at a dose of 40 mg.

Conclusion: The presented case is specific by its late onset since the patient experienced their first symptoms in fifties, which differs from the majority of cases where the diagnosis is usually established in young adults. Infectious factors are established as possible etiologic factors of MRS, but few cases are described to be triggered or worsened by COVID-19 infection. There is a need for further research to elucidate the impact of COVID-19 on the development and progression of Melkersson–Rosenthal syndrome.

Keywords: Melkersson-Rosenthal syndrome, granulomatous cheilitis, COVID-19, oligosymptomatic