A healthy 35-year-old white man complained of mild-to-moderate sensitivity in his lower incisor whenever he chewed for the past year. Four months ago, a painful tender swelling developed on his chin. The lesion began as a small pustule that subsequently ruptured. Culture revealed Staphylococcus aureus with sensitivity to ampicillin and tetracycline. Treatment with both antibiotics, in addition to local soaks, topical antibiotics, and heat, yielded no benefit. A skin biopsy performed by the patient’s primary-care clinician revealed an inflammatory reaction but no sign of malignancy. Because the lesion had failed to respond to treatment, the man was referred to me.
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