A 55-year-old Chinese woman presented with a persistent painless lower right lip lesion for a year (Fig. 1). She denied previous tattoos, infections or scars to the lip. No other skin lesions were present and she did not have any constitutional symptoms. She was given various topical and oral antibiotics without improvement. A biopsy was then performed and showed non-caseating granulomas. Anti-tuberculosis treatment was commenced, but there was no improvement after 2 months. At this stage, a chest X-ray revealed bilateral hilar prominence. This was confirmed by computed tomography (CT) scan and Gallium scan (Fig. 2) which also showed uptake in the orbital and nasal regions.
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