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A 35-year-old Caucasian man presented with a six-month history of recurring oral lesions after intense sun exposure. The lesions led to blistering and ulceration but did not spread to other parts of the body. When working as a lifeguard in his teens, the patient had been exposed to intense sunlight but had not developed oral lesions. He was generally healthy, with a history of occasional migraine headaches and gastroesophageal reflux disease. Various OTC treatments (L-lysine, docosanol) and acyclovir ointment provided no symptom improvement. Medications on presentation included omeprazole and ibuprofen.
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