Approximately 20 years ago, a 72-year-old Caucasian man developed frostbite whilst hunting in cold, dry, windy conditions at temperatures of around -35 C. Frostbite appeared after roughly 1 h of extreme cold exposure and presented initially as a white patch which later turned red. The lesion failed to heal, and after approximately 1 year, multiple scattered crusted plaques developed on the forehead at the site of previous cold injury (Fig. 3). Around 20 years after the frostbite incident, the man attended the Astana Oncology Center where an incisional biopsy was performed and a diagnosis of invasive SCC was made.