Asymptomatic plaque over the face in an elderly woman

A 50-year-old woman presented with an asymptomatic, slow-growing lesion over the face for 1 year.History of trauma, fever, joint pain, photosensitivity, weight loss, constitutional symptoms, and topical or systemic medications were lacking.On examination, a solitary, skin colored, non-tender, slightly indurated, compressible plaque, measuring about 1.5 × 2 cm was present below the left ala of the nose [Figure 1].Her hematological, biochemical, and urine routine were normal.Serology for infectious diseases was negative.Chest X-ray and ultrasound of the abdomen were normal.Slit-skin smears were negative for acid-fast bacilli.A biopsy was obtained.Histopathology showed an epithelial neoplasm with tumor islands [Figure 2a].Some of the tumor islands showed keratin cysts whereas others showed a cribriform pattern.Stroma was dense, rich in fibrocytes, and enveloped the tumor islands.Tumor islands showed peripheral palisading and at places, formation of germ and papilla structures [Figure 2b].e cells of tumor islands were follicular germinative cells lacking nucleoli, showing regular distribution of chromatin.