PMC9902074_01
Clinical and histopathological features of preceding skin lesion. (
A
) Solitary rodent-ulcer like pigmented papule on the left lower eyelid. (
B
) Histopathological specimen was compatible with basal cell carcinoma, showing numerous nests of basaloid tumors with peripheral palisading and peritumoral cleft. (
C-1
) Preoperative design on the left lower eyelid. (
C-2
) Photograph immediately after tumor removal.
(C-3
) Preauricular donor site. (
C-4
) Photograph immediately after skin graft.
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PMC9902074_01_10-1055-a-1988-2869-i22may0093cr-1.jpg
FI22may0093cr-1
A 57-year-old Korean man without any contributory medical history visited the dermatology department with a solitary pigmented papule, 0.4 cm in diameter, on the left lower eyelid ( Fig. 1A ). Skin biopsy revealed a basal cell carcinoma (BCC) with peripheral palisading and peritumoral cleft ( Fig. 1B ). After wide excision, FTSG from left preauricular area was used for reconstruction during plastic surgery ( Fig. 1C ). 
Clinical and histopathological features of keratoacanthoma (KA). (
A
) Solitary dome-shaped nodule with central keratotic plug on the left lower eyelid. (
B
) The center of nodule located on the lower margin of skin graft (red arrow head). (
C
) Large, well-differentiated squamous tumor with central keratin-filled crater, consistent with KA. (
D
) Excision with split-thickness skin graft was performed.
10-1055-a-1988-2869-i22may0093cr-2.jpg
PMC9902074_01_10-1055-a-1988-2869-i22may0093cr-2.jpg
FI22may0093cr-2
The nodule rapidly attained a dome shape with a central hyperkeratotic plug over the following 2 weeks ( Fig. 2A ). During dermatologic consultation, the patient was diagnosed with KA, and a surgical excision with 3 mm margin was performed ( Fig. 2B ). Histopathological findings revealed a large, well-differentiated, squamous tumor with central keratin-filled crater ( Fig. 2C ). The remaining defect was closed with a split-thickness skin graft harvested from the left lateral thigh ( Fig. 2D ).