The skin lesion was assesses as possibly related to a herpetic infection because it seemed to contained small vesicles. An excisional biopsy was performed.

The pathological findings revealed nests of atypical keratinocytes surrounded by myxoid stroma, peripheral palisading, individual necrotic keratinocytes and some mitotic figures.

A diagnosis of superficial basal cell carcinoma was made. The patient’s back syndrome improved with anti-inflammatory agents and physical therapy.