Journal Information
Vol. 109. Issue 5.
Pages 445 (June 2018)
Vol. 109. Issue 5.
Pages 445 (June 2018)
Images in Dermatology
DOI: 10.1016/j.adengl.2018.04.009
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Indurated Nodule on the Upper Lip
Nódulo indurado en labio superior
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A. Imbernón-Moya
Corresponding author
adrian_imber88@hotmail.com

Corresponding author.
, E. Fernández-Cogolludo, M.Á. Gallego-Valdés
Servicio de Dermatología, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
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A 54-year-old woman with no relevant past medical history consulted for an asymptomatic lesion that been growing progressively on her upper lip for 4 years. She reported no systemic symptoms and denied trauma, cosmetic procedures, application of topical products, and consumption of oral drugs.

The skin examination showed an irregular, well-delimited, normal-colored, indurated, mobile, nonpulsatile nodule on the left upper lip (Fig. 1A). There were no oral mucosal lesions and the locoregional lymph nodes were not enlarged.

Figure 1
(0.19MB).

We decided to perform a soft-tissue ultrasound before biopsy. The findings showed a solid, ovoid, well-defined, heterogeneous lesion with a diameter of 15mm and abundant arterial and venous flow. A subsequent computed tomography scan of the supra-aortic arteries showed a hypervascular lesion with intense arterial enhancement that was irrigated by the labial branch of the facial artery and the superior alveolar artery (branch of the maxillary artery) (Figs. 1B-D). Integration of the clinical and radiological findings (mainly the CT images) helped to confirm a diagnosis of caliber-persistent labial artery. The patient was referred to the vascular neuroradiology department for treatment.

Because of the risk of complications, skin or soft-tissue ultrasound should be requested before performing a skin biopsy in patients with an indurated lip nodule. Three-dimensional reconstructions are of great diagnostic value in vascular diseases and dermatological oncology.

Acknowledgments

We thank Dr. José Maria Abadal from the vascular radiology unit for his help in this case.

Please cite this article as: Imbernón-Moya A, Fernández-Cogolludo E, Gallego-Valdés MÁ. Nódulo indurado en labio superior. Actas Dermosifiliogr. 2018;109:445.

Copyright © 2017. Elsevier España, S.L.U. and AEDV
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