In response to the concern that our published Figure 2A1 may have represented Bowen disease with follicular invasion in a patient with cancer who was receiving hemodialysis, we provide 2 additional figures that were obtained from sectioning the entire tissue specimen. Histologic examination showed an atrophic epidermis with tumor cells extending into the dermis (arrows) as well as in association with follicles (Figure 1). At higher power, atypical keratinocytes and several mitoses were detected (Figure 2). The lesion was surrounded by a lymphohistiocytic inflammatory infiltrate and contained numerous small blood vessels and extravasated red blood cells. These findings are consistent with an invasive squamous cell cancer of high differentiation.
Hengge UR, Schaller J. Imiquimod and Squamous Cell Cancer. Arch Dermatol. 2005;141(6):787–788. doi:10.1001/archderm.141.6.787-b
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