PMC9838742_01
Clinical features of the patient. (A) Uneven hyperplasia on the upper and lower lips at the baseline examination. (B) The hyperplasia subsides obviously after tacrolimus 0.03% ointment treatment
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Physical examination showed uneven hyperplasia on the upper and lower lips (Figure 1A). The hyperplasia visibly subsided, and the patient was satisfied with the treatment (Figure 1B). In this case, the patient responded well to topical tacrolimus 0.03% ointment (Figure 1).
The RCM images of the dermis of the labial mucosa at the baseline examination. (A) Macrophages can be seen in the expanded dermal papilla. (B) Irregularly shaped, plump-bright cells with ill-defined borders and no visible nucleus can be seen, which correspond to macrophages phagocytizing red pigment particles. (C and D) Large numbers of expanded dermal papilla can be seen (red arrows), RCM vivablock mosaic shows macrophages phagocytizing red pigment granules merge to a quantity of irregular tubercles (red circles)
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The macrophages engulfed the pigment granules of the red tattoo and aggregated in a mass (Figure 2). In this case report, RCM imaging showed that the macrophages became irregular after phagocytosis of red pigment particles, and groups of macrophages gathered into irregular tubercles (Figure 2).