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The authors describe a 22-year-old woman with chronic painful gingivitis and macrocheilitis, eventually diagnosed after multidisciplinary review, exclusion of intestinal disease, and escalation to anti–TNFα biologic therapy. A literature review summarizes six similar cases, highlighting granulomatous histology, variable treatment responses, and the need for integrated clinical-histological-exclusion criteria and long-term monitoring.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/when-crohns-disease-is-confined-to-the-mouth-a-diagnostic-challenge-a-case-report-and-review-of-the-literature/461359/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/when-crohns-disease-is-confined-to-the-mouth-a-diagnostic-challenge-a-case-report-and-review-of-the-literature/461359.png","ImageObject",300,407,{"name":42,"@type":43},"Aldword","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is Oral Crohn’s Disease (OCD) and why is it difficult to diagnose?","Question",{"text":63,"@type":64},"OCD is Crohn’s disease confined to the oral cavity without gastrointestinal involvement. 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Failures or added systemic need led to systemic corticosteroids and, in some cases, systemic biologic therapy such as anti–TNFα; in the reviewed cases, corticosteroids helped most patients, while others required systemic or biologic therapy.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},461359,1790891115,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":116,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},2336478940917,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Review  \nWhen Crohn’s Disease Is Confined to the Mouth: A Diagnostic Challenge—A Case Report and Review of the Literature  \nAxel Vattier 1, Justine Chapuis 1, Marie Orliaguet 2, Amelie Bourhis 3, Franck Cholet 4, Laurent Misery 5 and Sylvie Boisramé 6, *  \nAcademic Editor: Andrew Day  \nReceived: 29 October 2025  \nRevised: 12 December 2025  \nAccepted: 15 December 2025  \nPublished: 19 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Dentistry, Oral Medicine and Oral Surgery, UFR Odontologie, Brest University Hospital, 29200 Brest, France; [axel.vattier@etudiant.univ-brest.fr](axel.vattier@etudiant.univ-brest.fr) (A.V.)  \n2 Laboratoire Interaction Epithelium Neurones, LIEN (UR 4685), Department of Dentistry, Oral Medicine and Oral Surgery, UFR Odontologie, Brest University Hospital, University of Brest,  \n29200 Brest, France; [marie.orliaguet@univ-brest.fr](marie.orliaguet@univ-brest.fr)  \n3 Department of Pathology, Brest University Hospital, 29200 Brest, France  \n4 Department of Gastroenterology, Brest University Hospital, 29200 Brest, France  \n5 Laboratoire Interaction Epithelium Neurones, LIEN (UR 4685), Department of Dermatology, UFR Medecine, Brest University Hospital, University of Brest, 29200 Brest, France  \n6 Inserm, EFS, UMR1078, GGB, Department of Dentistry, Oral Medicine and Oral Surgery, UFR Odontologie, Brest University Hospital, France University of Brest, 29200 Brest, France  \n* Correspondence: [sylvie.boisrame@univ-brest.fr](sylvie.boisrame@univ-brest.fr); Tel.: +33-2-98-01-64-89  \nAbstract  \nThis article explores a rare and diagnostically challenging form of Crohn’s disease, known as Oral Crohn’s Disease (OCD), in which the condition is confined to the oral cavity without gastrointestinal involvement. Additionally, Crohn’s disease is typically associated with digestive manifestations, and oral lesions may occasionally represent the first-or even the sole-signs of the disease, making diagnosis difficult due to their non-specific presentation. We report the case of a 22-year-old presenting woman suffering from chronic painful gingivitis and macrocheilitis, in the absence of gastrointestinal symptoms. Despite multiple topical treatments and an initial non-specific histopathological report, a multidisciplinary case discussion and re-evaluation of biopsies led to the diagnosis of OCD. Comprehensive gastrointestinal assessments revealed no intestinal involvement. Owing to the persistence of symptoms and resistance to topical therapies, the patient was subsequently treated with an anti–TNFα (Tumor Necrosis Factor alpha) biologic agent. To contextualize this case, we conducted a literature review and identified six similar cases published between 2000 and 2025 . Reported patients presenting with symptoms such as lip swelling, cheilitis, mucosal ulcerations, and gingivitis. Histopathological findings consistently demonstrate non-caseating granulomas and inflammatory cell infiltration. Most cases responded favorably to corticosteroids, while some required systemic or biologic therapy. The article highlights that OCD remains underrecognized due to its variable clinical presentation and absence of gastrointestinal manifestations. It emphasizes the importance of integrating clinical, histological, and exclusion-based diagnostic criteria and advocates for a multidisciplinary approach involving dental surgeons, dermatologists, pathologists, and gastroenterologists. Early recognition and long-term monitoring are essential, as gastrointestinal involvement may develop years after the onset of oral symptoms.  \nKeywords: Crohn’s disease; oral; biotherapies; gingivitis; oro-facial granulomatosis  \n1. Introduction  \nCrohn’s disease is a chronic inflammatory bowel disease that can affect the entire digestive tract, from the mouth to the anus [1] . I","cbCaijZhvyNeWRf1","https://ap.wps.com/l/cbCaijZhvyNeWRf1","pdf",2571735,"English","# Abstract\n# Keywords\n# 1. Introduction\n# 2. Materials and Methods\n## 2.1. Illustrative Case","[{\"question\":\"What is Oral Crohn’s Disease (OCD) and why is it difficult to diagnose?\",\"answer\":\"OCD is Crohn’s disease confined to the oral cavity without gastrointestinal involvement. Diagnosis is challenging because oral lesions can be the first or sole signs and often show non-specific clinical features.\"},{\"question\":\"How was the case diagnosed despite initial non-specific findings?\",\"answer\":\"A multidisciplinary discussion and re-evaluation of biopsies were used after multiple topical treatments and an initially non-specific histopathological report. Comprehensive gastrointestinal assessments then ruled out intestinal involvement.\"},{\"question\":\"What treatments are described for OCD, and what outcomes were reported?\",\"answer\":\"First-line management focuses on topical corticosteroids. Failures or added systemic need led to systemic corticosteroids and, in some cases, systemic biologic therapy such as anti–TNFα; in the reviewed cases, corticosteroids helped most patients, while others required systemic or biologic therapy.\"}]","When Crohn’s Disease Is Confined to the Mouth - A Diagnostic Challenge - A Case Report and Review of the Literature | PDF",1790761426,23]