Interesting Tumor

This 48 yo woman presented with a 2 year history of a tumor of the upper lip.
She has type III skin. The lesion in question is 6 mm in diameter.
A biopsy was done. This looks like a pigmented sclerotic basal cell.

She has a sick child and delayed her dermatology visit because she must take son to physicians often.
It's a three hour trip for him. He is 15 years old and has had polycythema rubra vera and essential thrombocythemia since age eight.