结合临床描述，要考虑疣状癌、高分化鳞癌。

炎症比较明显，上皮突延伸，需要谨慎鉴别疣状癌。

凯那红斑

 乳头状瘤伴炎症，和高分化鳞癌鉴别。

感觉没细胞异形， 乳头状瘤伴炎症。

考虑疣状癌、高分化鳞癌

临床是红斑还是丘疹，如果丘疹不能排除鲍温样丘疹病，如果糜烂性红斑，需要考虑凯那红斑！

乳头状瘤伴炎症，和高分化鳞癌鉴别。

缺少低倍图像，是鳞状上皮假瘤样增生还是"真瘤"是个问题。

疣状癌

良性病变，考虑炎症伴有疣状增生。

This is an awesome case. It features exophytic and endophytic epidermal hyperplasia with pallor changes in the keratinocytes. The rete ridges are elongated with blunted ends.  They cytologia atypia is absent. Intraepidermal infiltrates are present.  This differential diagnosis includes condyloma acuminatum, pseudoepidermal hyperplasia in verrucous keratosis, and cancer.

 In my opinion, this represents verrucouss carcinoma. It's usually diagnosed on architectural features and the cytology is  deceptively benign. So I echo 旅顺病理 -- a low power image is more valuable.

Warty carcinoma is in the differential diagnosis but is less favored due to: the lack of  characteristic condylomatous papillae and the lack of koilocytic changes.

鳞状细胞癌还是要考虑的。