A 72-Year-Old Man Is Evaluated Due to a Scaly Lesion

A 72-year-old man is evaluated due to a scaly lesion behind his right ear.  A diagnosis of squamous cell carcinoma is confirmed on biopsy, and the patient undergoes excision of the lesion with clear margins.  The wound is left to heal by secondary intention.  Three weeks later, the patient returns to the office with a 2.5-cm raised, soft, granular lesion at the excision site.  Biopsy of a representative lesion is shown in the image below: Which of the following is most likely responsible for this patient's postoperative changes?

A) Deposition of immunoglobulin-derived fibrils
B) Excess production of type I collagen
C) Proliferation of dysplastic keratinocytes
D) Recruitment and degranulation of neutrophils
E) VEGF-induced tissue proliferation

Correct Answer:

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