A patient consults a dermatologist about a skin lesion on her neck. Examination reveals a 1-cm diameter,red, scaly plaque with a rough texture and irregular margins. Biopsy demonstrates epidermal and dermal cells with large, pleomorphic, hyperchromatic nuclei. Which of the following conditions would most likely predispose this patient to the development of this lesion?
The lesion is a squamous cell carcinoma of the skin. Actinic keratosis, which is a hyperplastic lesion of sun-damaged skin, predisposes for squamous cell carcinoma. Another predisposing condition to remember is xeroderma pigmentosum, which predisposes for both squamous cell and basal cell carcinomas of skin. A nevus is a mole, containing characteristic cells called nevocellular cells. If the nevocellular cells are located at the dermal-epidermal junction (junctional nevus), in the dermis (dermal nevus), or both (compound nevus) they do not predispose for squamous cell carcinomas of the skin. Ref: Vujevich J.J., Goldberg L.H. (2012). Chapter 246. Cryosurgery and Electrosurgery. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick's Dermatology in General Medicine, 8e.
Actinic keratosis
Compound nevus
Dermal nevus
Junctional nevus