# Facial Skin Manifestation of a Destructive, Nonkeratinizing Squamous Cell Carcinoma

## TL;DR

This paper presents a rare case of nonkeratinizing squamous cell carcinoma spreading to facial skin, emphasizing the importance of early diagnosis and multidisciplinary care.

## Contribution

The novelty lies in highlighting the rare cutaneous extension of NKSCC and the role of p16 positivity in suggesting HPV-related etiology.

## Key findings

- An elderly male presented with extensive facial skin involvement due to biopsy-proven NKSCC.
- p16 positivity in the tumor suggests an HPV-related cause, which may affect prognosis and treatment.
- Early biopsy and dermatologist involvement are crucial for managing such aggressive tumors.

## Abstract

Nonkeratinizing squamous cell carcinoma (NKSCC) of the sinonasal tract is a rare malignancy that infrequently presents with cutaneous extension. This case describes an unusual instance of extensive facial skin involvement in an elderly male with multiple comorbidities, diagnosed with a biopsy-proven NKSCC. The tumor was p16 positive, suggesting an HPV-related etiology. This case emphasizes the critical role of dermatologists in the early diagnosis and multidisciplinary management of such aggressive tumors. It highlights the necessity of including NKSCC in the differential diagnosis of destructive facial tumors. Dermatologists should remain vigilant for rare presentations and employ early biopsy and histopathological examinations to facilitate prompt multidisciplinary intervention. Recognizing p16 positivity can indicate a human papillomavirus (HPV)-related etiology, potentially influencing prognosis and management strategies.