Challenges in the management of Melkersson-Rosenthal syndrome: a case report and systematic review.

Melkersson-Rosenthal syndrome (MRS) is a rare disease characterized by a triad of clinical signs: painless orofacial edema, recurrent facial paralysis, and fissured tongue. The classic triad appears in only 8% to 45% of cases. Monosymptomatic and oligosymptomatic forms are more frequent. Diagnosis of MRS is based on clinical history and examination findings, although some microscopic examinations may contribute. The objectives of this article are to report a case of MRS in a 63-year-old man and review the literature on the condition, offering comparative analysis of characteristics, behaviors, and therapeutic approaches. The patient described unilateral, painless, recurrent tongue edema, totaling approximately 10 episodes over a 1-year period. At the initial examination, the tongue was edematous and fissured but not swollen. Later images provided by the patient confirmed tongue swelling, and a diagnosis of MRS was established based on the presence of 2 of the 3 clinical signs of the classic triad. The patient received no drug therapy, but he was educated about the nature of the condition, provided with dietary recommendations, and scheduled for regular follow-up examinations. The dentist plays an important role in the diagnostic process for MRS, since the most significant changes occur in the orofacial region. Due to the rarity and diverse clinical presentations of MRS, there are few studies on the topic, and it is difficult to establish standardized treatment protocols. Most patients do not require treatment; when intervention is necessary, it is usually due to edema, which typically responds well to corticosteroid therapy.