We present histologic features of a locally advanced cutaneous squamous cell carcinoma treated with programmed cell death protein ‐1 (PD‐1) antagonist, pembrolizumab, with a partial response. This contributes to a growing body of literature supporting pembrolizumab's efficacy in treatment of surgically‐unresectable cutaneous squamous cell carcinoma. We also provide a detailed description of the histologic features, particularly keratin granulomata with adjacent lymphocytic aggregates and fibrosis, observed in cutaneous squamous cell carcinoma under treatment with a PD‐1 antagonist.
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