A case of disfiguring primary cutaneous squamous cell carcinoma of the nasal tip

We describe a 63‐year‐old Caucasian man who presented to our skin cancer unit because of a rapidly growing, ulcerated plaque on his nose, which he had first noticed 3 months previously. The ulcerated plaque involved the whole tip of the nose, which resulted in a significant disfigurement (Fig. 1). His personal and family medical history was unremarkable. He denied any type of trauma, chronic inflammation or infection at this site. On a physical examination, the lesion appeared as an indurated, infiltrating, well‐defined protruding ulcer with elevated borders, measuring 3.0 × 3.0 cm. A punch biopsy was taken and histopathology was interpreted as a well‐differentiated squamous cell carcinoma (SCC). Three weeks later, the tumour was surgically excised with a 6‐mm safety margin. Based on the histopathological examination of the whole tumour, the initial diagnosis of a well‐differentiated SCC was reversed into that of a poorly differentiated subtype without neural invasion or infiltration into the sub‐cutis. All resection margins were tumour‐free. There were no clinical signs of node involvement and further imaging, including a computed tomography of the head and neck and ultrasound of the cervical lymph nodes as well as a radiography of the chest showed no evidence of metastasis. The surgical defect was finally closed by rhinoplasty with an aesthetically and functionally good outcome. At the latest follow up of 3 years after the initial diagnosis the patient had no recurrence or metastases.