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The lower lip is most frequently involved, followed by both the concurrent upper and lower lips, with isolated upper lip involvement being rare.[1,2] LP cheilitis is usually limited to the vermilion, the area between the vermilion border and the labial mucosa (wet line)

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Most cases of methylmalonic acidemia are secondary to a complete or partial deficiency of L-methylmalonyl-CoA mutase, termed mut methylmalonic acidemia (46)