English
A 45-year-old female presented with macrocheilitis of the upper lip. Histologically numerous well-demarcated granulomas were present in the dermis and hypodermis. Examination under polarized light revealed birefringent crystalline particles. The patient had suffered a road accident 25 years ago. This case illustrates the characteristic features of silica granuloma without systemic manifestations. The clinical presentation as macrocheilitis may mislead into the wrong diagnosis.