OFG

Question 1

What is OFG?

Answer 1

Uncommon condition causing persistent swelling in lips/face/mouth
(Blockage of lymphatic drainage)

Question 2

What causes OFG?

Answer 2

Unknown
Thought to be related to an immune reaction/allergy
Presentation similar to Crohn’s disease therefore investigations for underlying disease are important

Question 3

What are the symptoms of OFG?

Answer 3

Lip/gum/face swelling
Ulcers
Tongue fissuring
Cobblestone mucosa
Dry red skin corners of mouth
Painful gums that may BOB
Pain eating hot/spicy/hard foods

Question 4

Can OFG be cured?

Answer 4

As the cause is not fully understood there is no curative tx but it can be controlled

Question 5

How is OFG diagnosed/tx?

Answer 5

1. Important to refer to GMP for screening: FBC,haematinics + stool test
   Crohns screening (as they can present similar)
   Growth monitoring
2. 3mth dietary exclusion - benzoic acid, sorbic acid, cinnamon, chocolate
   CHX + symptomatic relief for ulcers
   If no response - refer to specialists for topical corticosteroids
   Miconazole - angular cheilitis
   Tacrolimus ointment - 0.03%

Question 6

Examples of systemic immune modulators specialist tx

Answer 6

Azathioprine
Prednisolone