In Episode 8 of Med School Question of the Week for USMLE, Luke Maxfield, MedSchoolCoach expert tutor, answers this medical school question: An 81-year-old farmer presents to his primary care physician with a non-healing sore on his cheek. The patient has a past medical history of hypertension that is controlled hydrochlorothiazide. The patient reports he first noticed the spot as a scaly bump but that over the past six months it has progressively gotten larger and occasionally bleeds. The patient’s temperature is 36.6 celsius (94F), blood pressure IS 130/94 mmHg, heart rate is 76/min and regular, respirations are 12/min. Physical examination is notable for a hyperkeratotic papule over the left superior lateral cheek with a hemorrhagic crust. The lesion is shown in the image provided.