A 52-year-old Hispanic woman with a history of type 2 diabetes mellitus, hypertension, hypothyroidism, and a chondrosarcoma of the frontal cranium that had been excised and irradiated 3 years prior to presentation, was seen at the dermatology clinic with a 3-month history of a pruritic eruption in her left axilla. She had not used any new antiperspirants or deodorants and denied any antecedent trauma. Prior to presentation, she had treated the eruption with topical ketoconazole cream and topical bacitracin ointment without relief. On physical examination, the patient displayed brown hyperkeratotic papules coalescing into a slightly scaly and papillomatous plaque with a cobblestone appearance unilaterally on the left axilla (Figure 1). A skin biopsy specimen was taken (Figure 2).