Fig. 1.

(A) External photograph: 7.1 mm × 5.2 mm firm, nodular mass of the medial left upper eyelid, arising anterior to the gray line, with madarosis and telangiectasias on the surface. (B) Excisional biopsy revealing blue basaloid cells with multiple pink epithelial islands recapitulating immature hair follicles (few lumens filled with concentric laminated keratin). Malignant cells at the bottom right of the image show invasion into dermis (H&E, 10x). (C) Basaloid cells with clear cytoplasm, nuclear atypia, prominent nucleoli and atypical mitoses. Tumor cells form immature pilosebaceous units with trichilemmal keratinization and exhibit peripheral palisading (H&E, 40x). (D) Intermediate Ki67 positivity (Immunohistochemical stain, 20x).