M 74, ill-defined 1-cm keratotic lesion of his forehead.

    A 74-year-old Caucasian man presented with an ill-defined 1-cm keratotic lesion of his forehead. A shave biopsy showed (Figs.1 and 2) hyperkeratosis, parakeratosis, and moderate dysplasia of the keratinocytes. Dermis showed solar elastosis and non-specific focal chronic inflammation. The epidermis was raised upward by a subepidermal bulla containing eosinophilic acellular fluid. The basal lamina if the epidermis was intact. The epidermal cells overlying the bulla did not show any acantholysis. We interpreted the lesion as a bullous variant of solar keratosis.

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