A recognition of the different clinical appearances of epitheliomas is of great importance in determining the treatment to be employed. This statement applies decidedly to the scleroderma-like epitheliomas. CLINICAL CHARACTERISTICS This neoplasm grows slowly, and does not cause pain or other disturbance until late in its course and after it has attained considerable dimensions. Even then it is painless, and the patient's attention is finally drawn to it by a shallow easily bleeding ulcer that appears in the center of its field and refuses to heal, or if it temporarily heals, it quickly opens again. Sometimes the little ulcer is the only obvious feature, and the characteristic yellow, smooth field in which it is situated is perceived only when attention is drawn to it. Appearance.— The epithelioma is usually a small, circular, flattened plaque not more than a centimeter in diameter. It is either white or more frequently an ivory