What do you think of this changing lesion on the wrist?

In this week's case discussion, submitted by Dr David Stewart, we look at a 71-year-old female patient who presents with a changing lesion on her right wrist.

Last year she attended a local laser clinic and had the lesion treated a couple of times, but she does not feel the lesion ever fully cleared. It is now growing and becoming raised.

What do you think of this lesion?

Update

Please see pathology report below. You may be interested to read this paper which shows that at least some of the lesions we sample that are reported as lichenoid keratosis may actually be a benign growth or even a cancer that is spontaneously regressing.

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