60 yr m htn old cva lt hemiparesis.came to me nonhealing wound on lip since 4 yrs.ddx .rx pls.bsl n cbc wnl.

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Agree with dr anuj. May be he bite on lips to check lip sensation. Same like kids after anaesthesia return to clinic with lip biting if instruction not given. Pls check if his anteriors impinge on lower lip. Is his posteriors present? Check VDO. If diaturbed - establish that.

may b due to hemiparasis causing bad oral hygine. do go for biopsy

Sensory loss of lip due to hemiparesis might be a matter of concern.as you say patient had suffered from a cerebro vascular accident (cva) ,there might be some numbness of lip and consequently persistent trauma and infection.

May be lichen planus, local mild corticosteroid ointment.

But His lower facial profile resembles "Morgan Freeman " (the famous Hollywood star) :p

Sir aap bhi masti karne lage...i thought u r serious like nana patekar type. ....
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Cheilitis

is it glandular cheilitis???

more often present in lower lip nly
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Must be a tobacco chewer And smoker. I will think on line of malignancy and Investigate.

Probably cva related lip lesion Due to loss of sensation Duration of4 yrs demands a biopsy anyway that will clinch the diagnosis

Leukoplakia ,pre cancerous Biopsy from edge of lesion

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