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Cheilitis Granulomatosa. Presented by Margaret Ann Storkan, MD.
The patient is a 69-year-old warranty guard of English-Welsh descent, whose home is Utah. For three years he had noted changes in his upper lip with tender discrete nodules which appeared on the right side. In 1965, he had three surgical procedures for removal of these lesions; the specimen for examination from one of these surgeries is shown in Fig 1.For periods of two to three months he had taken antibiotics in oral doses with little change. The two courses of therapy in 1965 were completed about Jan 10, 1966. Since then, no medication has been suggested.Examination showed a diffuse edema of the upper lip; discrete, painful, irregular-sized nodules, some with puncta, which drain a mucopurulent material on the mucous membrane surface; and an elevated furuncle-like lesion on the skin surface.Gram stain of the purulent material
THE LOS ANGELES DERMATOLOGICAL SOCIETY. Arch Dermatol. 1966;94(5):660–666. doi:10.1001/archderm.1966.01600290134026
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