case_images: PMC3656680_01
case_images: Clinical picture of an erythematous plaque located on the frontal area of the face. The lesion showed a heterogeneous appearance with erythema, mild induration and an indistinct margin. The lesion had a size of 2.3 x 2.1 cm and had been present for over 10 years.
case_images: cde-0005-0129-g01.jpg
case_images: PMC3656680_01_cde-0005-0129-g01.jpg
case_images: F1
case_images: A clinical diagnosis of the erythematous lesion with a size of 2.3 x 2.1 cm was difficult due to the previously performed biopsies and treatments (fig. 1).
case_images: Clinical and RCM images of the SCC with the corresponding histology. a Clinically, an erythematosquamous plaque with an irregular border was located on the frontal area of the face. Depigmentation was mainly found in the cranial part of the lesion. b Corresponding hematoxylin-eosin stained tissue section displaying an invasive SCC (black arrows). c RCM image showing flattening of the dermal epidermal junction. Islands of dermal cells (encircled area) are interspersed between epidermal areas. d Tumor nest consisting of atypical epidermal cells (white arrow) surrounded by fibrosis (asterisk). e Spongiosis, visualized as enlargement of the bright intercellular spaces. f Keratinocyte atypia at the stratum spinosum. g Severe solar elastosis was seen in the dermis, visualized as coarse, highly reflective collagen bundles.
case_images: cde-0005-0129-g02.jpg
case_images: PMC3656680_01_cde-0005-0129-g02.jpg
case_images: F2
case_images: More importantly, one small part showed prominent aberrant features: a disrupted stratum corneum, keratinocyte atypia, spongiosis, increased capillary blood flow, flattening of the dermal epidermal junction, solar elastosis and a nest of atypical cells (fig. 2).