Past medical history includes alcoholism and intravenous heroin abuse and is currently undergoing methadone therapy. The border of the raised erythematous facial swelling though irregular, is sharply demarcated from the adjacent skin and extends from the tragus to the right paranasal area. It extends superiorly to the right periorbital region and inferiorly to the right commissure of the mouth. The lesion is exquisitely tender and hot on palpation. There is no evidence of disruption of the skin barrier.
Visual acuity is normal.
The sclera are clear and there is full range of ocular movement. Oral examination does not reveal periodontal disease caries, or tooth pain. Upper extremity examination reveals needle tract markings. No murmur, petechiae, splinter hemorrhages, Osler's nodes, Roth spots, Janeway lesions, or splenomegaly are noted. The remaining physical examination is normal.