A 69-year-old white man presented with a 4-month history of a rapidly growing nodule on his midforehead area. The lesion was nontender but bled intermittently. The patient denied having any previous radiation exposure or trauma, and his medical history was otherwise unremarkable.
Physical examination revealed a 5.0 × 5.2-cm, well-circumscribed, exophytic, friable, fungating plaque with an overlying hemorrhagic crust on the superior aspect of the midforehead region (Figure 1). No cervical lymphadenopathy was noted. A deep wedge biopsy specimen was sent for microscopic examination and tissue culture (Figure 2 and Figure 3).
Lockshin BN, Billings SD, Tan SR, Swofford M, El-Gamal HM. Fungating Forehead Plaque—Quiz Case. Arch Dermatol. 2006;142(8):1059-1064. doi:10.1001/archderm.142.8.1059-a