52-year-old man with pink-yellow papules   

History and Images

Our appreciation is extended to Dr. Natalia Velez-Lopez and Dr. Zully Gonzalez-Lopez, University of Antioquia in Medellin, Colombia, for contributing this case.

History: A 52-year-old man presented an asymptomatic but growing lesion on his right nasal ala. He said the lesion appeared six months ago, and he reported asymptomatic bumps on the central area of his face that he had had for several years that in previous biopsies resulted in benign lesions of which he couldn’t recall the name. Clinical and microscopic images are presented.

Click images to enlarge.

What is the most likely diagnosis based on morphology and histology?
Basal cell carcinoma
Sebaceous carcinoma
Sebaceous adenoma
Squamous cell carcinoma

This lesion in an older adult could be the marker of a genodermatosis.

The nature of this lesion is aggressive.