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Keratinocyte carcinomas (KCs) are now an epidemic in The United States of America, especially in elderly patients. KCs, including basal cell carcinoma and squamous cell carcinoma, can lead to disfigurement and occasionally death. However, the lower mortality rate associated with KC compared with melanoma allows for increased flexibility in the selection of treatment. Flexibility in treatment is particularly important in the elderly given that this patient population often has medical comorbidities that should be considered. These patients may have multiple KCs, higher risk tolerance to recurrence, and different concerns about cosmetic outcomes compared with their younger counterparts. We review treatment options for KCs and how the selection of each option may affect the elderly patient.

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This is a case of a patient presenting with pruritic dark plaques that erupted on the upper extremities and the left inner thigh. The patient is otherwise asymptomatic with no other acute concerns. A multiple-choice question is presented and readers will be challenged to diagnose this patient based on the case presentation, symptoms, and patient history. An answer is given followed by a discussion of the diagnosis, clinical features, and therapeutic management.