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Case Report Open Access

Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report

  • Authors:
    • Alina Teresa Sánchez Vázquez
    • Anahí Parcero Tamay
    • María J. Calvo Domínguez
    • Martha Patricia Pacheco Arenas
    • Valeria Iuxely Medrano Pichardo
  • View Affiliations / Copyright

    Affiliations: Department of Internal Medicine, ‘Dr. Belisario Domínguez’ General Hospital ISSSTE, Tuxtla Gutiérrez, Chiapas 29040, Mexico, Department of Pediatrics, High Specialty Regional Hospital of Zumpango, Zumpango de Ocampo 55600, Mexico, Department of Medicine, Clínica Hospital ISSSTE Río Bravo, Ciudad Río Bravo, Tamaulipas 88970, Mexico
    Copyright: © Sánchez Vázquez et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 10
    |
    Published online on: December 31, 2025
       https://doi.org/10.3892/mi.2025.294
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Abstract

Melkersson‑Rosenthal syndrome (MRS) is a rare neuro‑mucocutaneous disorder characterized by recurrent orofacial edema, peripheral facial palsy and a fissured tongue, although the complete triad is rarely observed. The present study reports the case of a 22‑year‑old male patient who initially presented with facial paralysis, later developing cheek edema, dermatosis and systemic symptoms; the histopathological findings consistent with granulomatous cheilitis. Laboratory analyses revealed a low C1q level and positive antinuclear antibody. Based on clinical and biopsy findings, MRS was diagnosed. The patient responded well to a 6‑month regimen of deflazacort, epinastine and methotrexate. On the whole, the present case report illustrates an incomplete, yet clinically significant form of MRS. Diagnosis is primarily clinical, supported by histology and exclusion of similar conditions. Treatment focuses on symptom control with corticosteroids; immunomodulators or biologics may be used in refractory cases. Early recognition is essential, even in the absence of the full triad.
View Figures

Figure 1

Clinical images illustrating the
presentation and progression in a patient with Melkersson-Rosenthal
syndrome. (A) Facial dermatosis characterized by localized facial
edema at initial consultation. (B) Clinical improvement with
visible reduction of edema after six months of treatment with
methotrexate. (C) Presence of fissures on the lateral borders of
the tongue (black circle).

Figure 2

Histopathological findings of lower
lip mucosa biopsy in Melkersson-Rosenthal syndrome. (A) Moderate
irregular acanthosis (red arrows) and focal hydropic degeneration
of the basal layer (black star) (magnification, x10). (B)
Inflammatory infiltrate composed of lymphocytes, histiocytes,
neutrophils and plasma cells, focal hydropic degeneration of the
basal layer (black star) and mixed inflammatory infiltrate (black
arrowhead) and dilated, congested blood vessels (magnification,
x40).
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Copy and paste a formatted citation
Spandidos Publications style
Sánchez Vázquez AT, Tamay A, Calvo Domínguez MJ, Pacheco Arenas MP and Medrano Pichardo VI: Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report. Med Int 6: 10, 2026.
APA
Sánchez Vázquez, A.T., Tamay, A., Calvo Domínguez, M.J., Pacheco Arenas, M.P., & Medrano Pichardo, V.I. (2026). Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report. Medicine International, 6, 10. https://doi.org/10.3892/mi.2025.294
MLA
Sánchez Vázquez, A. T., Tamay, A., Calvo Domínguez, M. J., Pacheco Arenas, M. P., Medrano Pichardo, V. I."Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report". Medicine International 6.1 (2026): 10.
Chicago
Sánchez Vázquez, A. T., Tamay, A., Calvo Domínguez, M. J., Pacheco Arenas, M. P., Medrano Pichardo, V. I."Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report". Medicine International 6, no. 1 (2026): 10. https://doi.org/10.3892/mi.2025.294
Copy and paste a formatted citation
x
Spandidos Publications style
Sánchez Vázquez AT, Tamay A, Calvo Domínguez MJ, Pacheco Arenas MP and Medrano Pichardo VI: Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report. Med Int 6: 10, 2026.
APA
Sánchez Vázquez, A.T., Tamay, A., Calvo Domínguez, M.J., Pacheco Arenas, M.P., & Medrano Pichardo, V.I. (2026). Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report. Medicine International, 6, 10. https://doi.org/10.3892/mi.2025.294
MLA
Sánchez Vázquez, A. T., Tamay, A., Calvo Domínguez, M. J., Pacheco Arenas, M. P., Medrano Pichardo, V. I."Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report". Medicine International 6.1 (2026): 10.
Chicago
Sánchez Vázquez, A. T., Tamay, A., Calvo Domínguez, M. J., Pacheco Arenas, M. P., Medrano Pichardo, V. I."Melkersson‑Rosenthal syndrome with facial swelling and palsy and associated diagnostic challenges: A case report". Medicine International 6, no. 1 (2026): 10. https://doi.org/10.3892/mi.2025.294
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