Orofacial manifestations of Crohn's disease can be difficult to diagnose an
d treat. We report a case in which the orofacial lesions occurred 7 years p
rior to the diagnosis of underlying inflammatory bowel disease. The patient
was refractory to mesalamine and systemic corticosteroids but responded to
infliximab, the chimeric monoclonal antibody to tumor necrosis factor (TNF
-alpha). A review of the literature of the orofacial granulomatoses is pres
ented as well.