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November 1988

Persistent Swelling of the Lower Lip

Author Affiliations

Hospital of the University of Pennsylvania, Philadelphia

Arch Dermatol. 1988;124(11):1707-1708. doi:10.1001/archderm.1988.01670110067015

REPORT OF A CASE  A 62-year-old woman was well until eight weeks prior to evaluation when she develped, over a 24-hour period, painless edema of the lower lip without any provoking incident (Fig 1). The edema was more pronounced in the morning, with partial resolution later in the day. No palliation was achieved by warm or cold compresses, courses of several antihistamines, or a seven-day course of erythromycin therapy. There was no history of applied irritants, sensitizers, trauma, prolonged light exposure, photosensitivity, or facial paralysis.Physical examination revealed swelling of the lower lip with moderate fissuring of her tongue and resolving angular cheilitis. There was no regional lymphadenopathy.A biopsy specimen was obtained from the lower lip (Fig 2).What is your diagnosis?

DIAGNOSIS:  Cheilitis granulomatosa.

HISTOPATHOLOGIC FINDINGS  A punch biopsy of the lip revealed spongiosis of the partially keratinized squamous mucosa. There was a patchy

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