Derm Dx: Swollen Lesion on the Lower Lip - Clinical Advisor

Derm Dx: Swollen Lesion on the Lower Lip

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A 63-year-old man presents for evaluation of a 5-day history of painful swelling affecting his lower lip. He denies antecedent trauma to the site. He does not have diabetes. He is a nonsmoker and drinks alcohol in moderation. Examination reveals an erythematous, 1.5-cm nodule that is tender to palpation. Cervical and submandibular lymph nodes are not palpable.

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Although lip abscesses are uncommonly reported in the medical literature, they may appear when  they result in serious sequelae.1,2 One can assume that most cases have satisfactory outcomes without medical intervention, although some clinicians advocate treatment with intravenous antibiotics and...

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Although lip abscesses are uncommonly reported in the medical literature, they may appear when  they result in serious sequelae.1,2 One can assume that most cases have satisfactory outcomes without medical intervention, although some clinicians advocate treatment with intravenous antibiotics and urgent surgical drainage.2 Exogenous factors reported to induce lip abscess formation include bee stings and silicone injections for lip enhancement.3,4 Lip abscesses have also been reported in association with isotretinoin therapy for acne.5

The patient’s lesion was punctured and expressed copious pus. He was placed on treatment with cephalexin; on follow-up examination 1 week later, the site had fully resolved.

Stephen Schleicher, MD, is director of the DermDox Center for Dermatology, as well as associate professor of medicine at Commonwealth Medical College and clinical instructor of dermatology at Arcadia University and Kings College.

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References

  1. Bruno GJ, Bruno JM, Miyake AA. Community-acquired methicillin-resistant Staphylococcus aureus infection with fatal necrotizing pneumonia from lip abscess: a case report. J Oral Maxillofac Surg. 2007;65(11):2350-2353.
  2. Godoy-Gijón E, del Pozo-de Dios JC, Román-Curto C. [Bacterial lip abscess in an immunocompetent patient]. Dermatol Online J. 2013;19(4):13.
  3. Alemán Navas RM, Martínez Mendoza MG, Herrera H, de Herrera HP. Floor of the nose mucosa lysis and labial abscess caused by a bee sting. Braz Dent J. 2009;20(3): 249-253.
  4. Schmidt-Westhausen AM, Frege J, Reichart PA. Abscess formation after lip augmentation with silicone: case report. Int J Oral Maxillofac Surg. 2004;33(2):198-200.
  5. Huoh KC, Chang KW. Lip abscess associated with isotretinoin treatment of acne vulgaris. JAMA Dermatol. 2013;149(8):960-961.
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