here's what the hospital said:
A 16-year-old boy presented to our hospital because of a huge mass on the face and a large ulcer on the scalp. Physical examination revealed a giant necrotic, ulcerating mass involving the two third upper part of the face (Fig. 23.1) and an ulcer sized 10 × 7 cm on the cranial vertex of the scalp (Fig. 23.2). The mass covered almost the two eyes and half of the nose with multiple bleedings and pus-discharging. This mass had been gradually progressing for the last 7 years. There were also diffuse hypo-hyperpigmented atrophic lesions all over the body (Fig. 23.3). His skin was unnaturally dry and rough. Telengiectases were observed over some lesions. These lesions have increased over the skin since the age of three. There was no palpable lymph node. He had a significant alteration of general condition with a BMI (body mass index) of 13.6 kg/m2. He has a family history of consanguinity, but no other person in the family has similar presentation.
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