Concluded Case

Case : A 70 year old man complains of a large pink lesion on his cheek that oozes and bleeds. It never seemed to heal properly. No significant past history and family history. All other vitals are normal. Diagnosis and management? Image below shown lesion-

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Concluded answer

Keratoacanthoma...

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Non healing ulcer cheek. Basaloid cell groups and nests Peripheral pallisadiing ..cellular and nuclear..in Upper dermis. Fibroplasia Chronically inflamed drrmis. P.O BASAL CELL CARCINOMA..PROBABLY FIBROEPITHELIOMA OF PINKUS

? Keratoacanthoma ? SCC

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Image 1 : evertrd edges with raised margin Mostly KERATOSCANTHOMA ? SCC

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Pyogenic granuloma Ulcerated capillary hemangioma.

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Basal cell carcinoma also called rodent ulcer Treatment is surgery if cosmetically acceptable, otherwise I would recommend Radiotherapy. Mould brachytherapy. If EBRT is only available then plan electrons available in a linac. If your machine is a telecobalt, then use a bolus over the ulcer. Hypofractionation is better for skin ulcers

?Keratocanthoma

Keratoacanthoma...

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