Human leucocyte antigen typing in orofacial granulomatosis

Sir, Wiesenfeld et al. introduced the term orofacial granulomatosis (OFG) in 1985 to describe a constellation of oral and facial signs resembling those of Crohn’s disease (CD) clinically and histologically in patients who do not appear to have abnormalities at any other site in the gastrointestinal tract.1 Patients with OFG may be referred to a dermatologist for management, as the condition can present as persistent facial swelling which may affect the lips, cheeks, eyelids and forehead.2 Intraoral abnormalities include mucosal tags, cobblestoning and a ‘full thickness’ gingivitis; oral ulceration tends to be recurrent and of the aphthous‐type although some may be deep and persistent.1 Worsaae et al. studied 16 patients with established OFG and found none with gastrointestinal CD.3 Scully et al. reviewed 19 patients with OFG and found seven (37%) to have gastrointestinal CD.4 There remains great disparity of opinion in the literature over whether or not OFG is a discrete clinical entity, a manifestation of CD, or a manifestation of a new variant of inflammatory bowel disease. Gibson et al. have suggested an allergic basis for OFG.5 This study aimed to determine whether or not patients with OFG had human leucocyte antigen (HLA) types in common, or distinct from, those of CD, as determined in the current literature.