Case Number : Case 1972 - 20 Dec 2017 Posted By: Iskander H. Chaudhry

Irritated Seborrheic Keratosis...a bit odd. 

My concern would be for a well differentiated invasive cystic SCC, especially in a 70 year old on the face.

Do the coarse keratohyaline granules suggest a viral etiology? Also, what is the significance of pigment incontinence and granulomatous infiltrate?

Keratoacanthoma ( en plaque?)

Dear All I have added the BerEp4 so my question is: 

1. Is this a basisquamous carcinoma?

2. BCC with reactive squamous proliferation adjacent to it ?

3. Other!

Difficult to explain all the features under one heading. Looks like BCC + inflamed SK + granulomatous rosacea

basal cell carcinoma associated with a ruptured inclusion epidermoid cyst like lesion

I go for basosquamous for further correlation with the excised specimen

Still worried about a keratoacanthomatous invasive SCC.

This is a BCC. PEH is most likely although KA can occur with BCC etc. Not worried for SCC here.