A 25-year-old male with a...

A 25-year-old male visited the clinic with a skin concern. He had a single, slowly growing skin lesion on his face that had been present for about 10 years. Although the lesion was painless, it occasionally discharged fluid, became ulcerated, or bled. The patient had been using various topical and systemic treatments, including steroids, antibiotics, and antifungals, for several years, but none of them had improved the condition. His medical history, family history, and overall health were normal. During the skin examination, a solitary, rounded, fleshy plaque with central crustation, measuring 3 × 3 cm, was observed on the right side of his face. There were no signs of lymphadenopathy (enlarged lymph nodes). To investigate the lesion further, a punch skin biopsy was performed. The biopsy results revealed specific characteristics of the lesion. The epidermis displayed downward papillomatous extensions, which are projections of the skin's outer layer. In the dermis, multiple epithelial sheets and dilated ducts were observed. These ducts were lined by columnar cells, a type of elongated cells with specific features.