Review Question - QID 213186

A 63-year-old man presents to his primary care provider complaining of an enlarging red area on his forehead that recently opened up and is now ulcerating. The patient reports that he first noticed the lesion 6 months ago, when he thought it was a pimple. He denies any antecedent trauma to the area. Of note, the patient works as a parking lot attendant and has a history of 2 basal cell carcinomas on his neck that were previously excised. On exam, his temperature is 98.8°F (37.1°C), blood pressure is 132/82 mmHg, pulse is 70/min, and respirations are 12/min. On the forehead, there is an erythematous patch approximately 3 centimeters at greatest diameter with surrounding scale and central ulceration of 0.5 cm. The patient is referred to a dermatologist and the lesion is excised. The histopathological slide is shown in Figure A. Which of the following is most associated with this type of lesion?