A long-standing plaque in the cutaneous upper lip of a late middle-aged man

Our patient was a 68-year-old man who presented with a firm, immobile, asymptomatic, colorless nodule on the upper lip (Figure 1), which he described as being present for the past twenty years. The lesion had been growing recently without any other symptoms. The patient had no history of facial trauma, immunodeficiency, and radiotherapy. However, the patient had a positive history of prolonged sun exposure as a part of his occupational hazards. The cystic lesion was excised from his upper lip and was sent for histopathological examination, which reported: “numerous islands and some cords of basaloid cells with small keratinous cyst formation involving the superficial and deep dermis and subcutaneous fat” (Figure 2). There were foci of duct differentiation, a few with comma-like tails (Figure 2). Low mitotic figures & mild pleomorphic cellular shapes were seen. The stroma was dense and hyalinized, consisting of thickened collagen bundles.