A 46-year-old serviceman deployed to Iraq presented with a papule on his lower lip that had developed over four weeks. Two days after the patient nicked his lip with a razor, a small, red, tender bump appeared. Over the next few weeks, the bump became firmer and slowly enlarged. Although the patient had received multiple insect bites in the previous weeks, he did not recall any on his lips. He had no fever or chills. He had used smokeless tobacco for 20 years and had moderate sun exposure as a child and adult.
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