This shows a hyperaemic skin lesion with ulceration. It is surrounded by an area of cellulitis. It could be a primary skin carconima, such as a squamous carcinoma or possibly an amelanotic melanoma. It could also be a skin secondary eg a bronchogenic or breast carcinoma. It may simply be an inflammatory lesion or due to local injury with secondary infection. An incisional biopsy is required to establish the diagnosis. This proved to be a squamous carcinoma of the skin.