Oral Crohn's disease: report of two cases in brothers with metallic dysgeusia and a review of the literature.

Between 4% and 14% of patients with intestinal Crohn's disease (CD) may manifest the typical oral changes of this disorder. These changes include labial and intraoral inflammatory tissue hyperplasia with fissuring ("cobblestoning") and swelling. In addition, angular cheilitis and regional lymphadenopathy may be present. We report two cases of oral CD in brothers, in whom the unusual symptoms of metallic dysguesia and gingival bleeding were prominent features. Despite the well-recognized familiar incidence of CD, a review of the literature shows that in no previous case reports has familial oral CD been noted. Successful symptomatic and objective treatment results were obtained with a mouthwash preparation of triamcinolone acetonide, tetracycline, and lidocaine.