The patient is a 22-year-old woman who presents complaining of frequent nosebleeds. On exam, you note bright red macules and spider veins on her lips and tongue. They disappear briefly when you press on them.

Review the image below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 22-Year-Old Female with Frequent Nosebleeds and Abnormalities on Her Lips and Tongue
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