JAMES M.GRICHNIKMD, PhD
A 66-year-old man presented for evaluation of an ulceration behind the left auricle that persisted after surgical removal of a basal cell carcinoma 6 months earlier. The defect from that surgical procedure had been covered with a split-thickness graft, and no postoperative complications were reported. Under the clinical diagnosis of a recurrence of the basal cell carcinoma, this ulceration was completely excised. The histologic examination, however, revealed a tessellation consisting of flamboyant tracerylike motifs with a strong foreign-body reaction but no signs of the prior basal cell carcinoma (eg, nests of atypical basaloid cells and peripheral palisade) (Figure). Detailed anamnesis revealed that the polyurethane foam that had been used for temporary wound dressing to induce the formation of granulation tissue had not been removed prior to skin grafting.
Becker JC, Vetter CS. Art in Dermatologic Surgery. Arch Dermatol. 2005;141(9):1186. doi:10.1001/archderm.141.9.1186