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Soft, round bump located in the center of lip. Had lip surgery. Taking medrol packs and applying a steroid. Could I ask a doctor?

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General & Family Physician
Practicing since : 2009
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I have had a soft, round bump that is located at the direct center of my top lip. This bump first came as a reaction to chapstick use in January. Almost fully went away a few days later, but still felt soft fluid somewhat inside my lip. Bump came up again in May after chapstick use. Has not gone down since then. Had lip surgery in August because doctors thought it was a mucocele, but she did not find anything irregular. Being tested for HSV this week. Any other ideas? Been on two medrol packs which temporarily decreased the size of the bump, but became inflamed again shortly after I finished the steroids. Ice doesnt seem to help take down inflammation. Been given a topical steroid to apply to my lip at night and that doesnt seem to work either. Seems like a medical mystery. Would appreciate any help.
Posted Mon, 11 Nov 2013 in Skin Hair and Nails
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer:
A few possibilities; more tests

Detailed Answer:
Hello ma'am and welcome.

I have gone through your query with diligence and also looked at the attached image of your lip. The first thought that would come to mind is an allergic reaction or an insect bite.

As mentioned by you, you did experience the same after the use of chapstick, and so it should be quite clear to initiate the use of both antihistamines and anti-inflammatory medication. I see that steroids have been initiated to reduce the inflammation, but I have not seen anti-histamines being mentioned anywhere in your query. Please request your doctor for the same.

Let me also list all the possible causes for a swollen lip, so you could relate to them, or rule them out to consider others. They are:
-Allergic reactions
-Insect bites
-Herpes simplex virus
-Bacterial infections (will have other symptoms like fever, increased temperature locally, local redness, pus discharge from the region, pain, etc.)
-Erythema Multiforme
-Side effects to medication used
-Vitamin B12 deficiency

I would advise an ultrasound of the region, blood investigation ro check on vitamin B12 levels, herpes status check, check on eosinophil levels, and a systemic examination for now. Do the following and then we shall look into other causes.

I hope this helps to reach the diagnosis. Please feel free to update me on any other tests conducted or any general updates altogether. I am here to help always.

Best wishes.
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