A 65-year-old man presented with a pearly-to-yellow-colored papule on the medial commissure of his left eye. He had first noticed the lesion about one month earlier and was concerned that it was getting larger. The lesion was not painful, and although there had been recent moderate bleeding, the patient had not sought any previous therapy. The man had recently retired after 45 years as a roofer. Physical examination revealed diffuse actinic keratoses on sun-exposed areas. He had no history of similar lesions.


A 55-year-old man visited the dermatology clinic for evaluation of a yellow papule that had been present on his left cheek for several months. The patient had not observed any change in the lesion’s size or appearance, and he had not tried any treatments. The growth was not painful and did not bleed. On questioning, the patient admitted to moderate sun exposure, albeit with daily sunscreen use. Physical examination revealed scattered actinic keratoses. There was no history of similar lesions.

What is the diagnosis?

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