26th April 2024

A 72-year-old man presents with a lesion on his nose that he first noticed 2 years ago.

A 72-year-old man presents with a lesion on his nose that he first noticed 2 years ago. The lesion initially appeared as a small, shiny nodule and has gradually increased in size. Recently, the centre of the lesion has begun to ulcerate and occasionally bleeds. The patient reports no pain but is concerned about the cosmetic appearance. He has a history of extensive sun exposure due to his career as a gardener. On examination, the lesion measures 1 cm in diameter, with a pearly edge and telangiectatic vessels visible on the surface.

Which is the most likely diagnosis?