History: This lesion arose rapidly in an immunosuppressed patient who had a transplant. It has the typical morphology of a keratoacanthoma with the domed shape and central keratin core.However at least 10% of SCCs may present looking like this and a diagnosis of SCC is more likely in an immunosuppressed patient. The lesion was initially curetted. It shows the relatively superficial growth characteristics of this tumour. In people with a normal immune system these lesions may spontaneously involute and fall off!