A 20-year-old man presented with a 2-year history of a persistently red and swollen lower lip. He stated that the lip always felt moist and had areas of crusting. There was no history of bleeding or pain. The patient did not report lip licking or an outdoor occupation. He denied alcohol and tobacco use. He had applied an unknown lip balm from Mexico and a commercially available lip moisturizer (Chapstick; Wyeth Consumer Healthcare, Richmond, Va) for several months, without improvement. He was otherwise healthy.