Foreign-body (silica) granuloma of the lip

A foreign-body granuloma may occur in the lip secondary to traumatic implantation of dirt and sand. Several recommendations for the clinician encountering such contaminated wounds follow. Debridement of the wound and copious flushing are of primary importance as a preventive measure. The patient should be informed of possible sequelae and advised to seek treatment if nodules occur in later years. The development of a granulomatous response necessitates initial surgical intervention to establish the histologic diagnosis; however, repeated surgical procedures are not indicated unless subsequent enlargements cannot be resolved by intralesional injection of steroids. Last, it must be emphasized that a histologic diagnosis of a granulomatous lesion obligates the oral and maxillofacial surgeon to request additional studies to rule out a systemic involvement.