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JAMA Dermatology Clinicopathological Challenge |

Persistent, Nontender Lip Swelling in a Patient With HIV QUIZ

Ryan Gillihan, BS1; Ryan Fischer, MD2; Jennifer Cafardi, MD3
[+] Author Affiliations
1School of Medicine, University of Kansas Medical Center, Kansas City
2Division of Dermatology, University of Kansas Medical Center, Kansas City
3The Christ Hospital, Cincinnati, Ohio
JAMA Dermatol. 2015;151(12):1369-1370. doi:10.1001/jamadermatol.2015.2788.
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A man in his early 40s with a history of verruca vulgaris, dyshidrotic eczema, and HIV presented with a chief complaint of dry, swollen lips, a 1-month history of “puffy and bumpy” lips, and a sometimes “dry and scaly” lower lip but no bleeding. What is your diagnosis?

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Clinical images (A and B) show persistent, nontender swelling of the lips in a patient with human immunodeficiency virus, showing erythematous papules at the vermillion border and edema of the lower lip. C and D, Histologic images of a biopsy specimen from a papule on the lower lip show, at low magnification (C), a nodular, nonnecrotizing granulomatous dermatitis and, at higher magnification (D), the presence of epithelioid histiocytes with admixed lymphocytes.

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