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A 31-year-old woman presented with a year of recurrent lower lip swelling with associated oral ulcers ( Figure A ). Labs were notable for an elevated C-reactive protein and hypoalbuminemia. A punch biopsy of her lower lip showed granulomatous dermatitis with lymphangiectasia, and she was given the diagnosis of orofacial granulomatosis ( Figure B ). Resolution of symptoms only occurred with chronic prednisone.
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