73 year old uninsured male patient presents to clinic for up | Figure 1

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73 year old uninsured male patient presents to clinic for upper body skin exam. Patient has an extensive amount of actinic damage noted on face and upper extremities and this large pink asymptomatic plaque is noted during exam. Patient states it has been present for a few years and he "didn’t think much about it". He denies significant growth but stated that it may have enlarged a little over the years. Although he deferred lower body skin exam, there were no similar lesions noted on trunk or upper extremities. What is your differential diagnosis for this patient?

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