Description: non-polarising dermoscopy shows multiple milia cysts. Centrally vessels are arborising, and peripheral vessels are not hairpin, counting against clinical diagnosis of keratoacanthoma

History: Rapidly enlarging preauricular nodule, arising over only 2 weeks. History suggested keratoacanthoma, but histology was reported as Sections show a cystic basal cell carcinoma with matrical differentiation. It extends into deep dermis.