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Derm Dx: Hyperkeratotic Plaque on the Chest

A 73-year-old man presents for evaluation of an asymptomatic lesion on his chest noted several months previously. The patient is fair skinned, and his medical history is positive for both actinic keratoses and squamous cell carcinoma in situ. Examination reveals a 1.2-cm slightly hyperkeratotic plaque as well as scattered seborrheic keratoses.