\documentclass[12pt,a4paper]{book}
\usepackage[utf8]{inputenc}
\usepackage[T1]{fontenc}
\usepackage{xcolor}
\usepackage{tikz}
\usepackage{enumitem}
\usepackage{tcolorbox}
\usepackage{lipsum}
\tcbuselibrary{vignette}
\begin{document}
\begin{itemize}[label={\begin{tikzpicture}\node[draw,fill=blue!15!white] (A) {FACT};\tcbvignette{outside node=A,raised color=blue}
\end{tikzpicture}}]
\item \lipsum[1]
\item \lipsum[1]
\end{itemize}
\end{document}
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[baseline=(A.base)]is used. – Qrrbrbirlbel Jul 24 '23 at 12:26\begin{tikzpicture}[baseline=(A.base), overlay] \node[draw,fill=blue!15!white] (A) {FACT}; \tcbvignette{outside node=A, raised color=blue} \path[overlay=false] ([xshift=-2mm]A.west) ([xshift=2mm]A.east); \end{tikzpicture}where2mmis the defaultsizefor the vignette. This makes the picture have a width for the proper positioning but no height so that it doesn't interfere with the linespacing of the paragraphs. – Qrrbrbirlbel Jul 24 '23 at 12:33