We present the case of Kindler syndrome in a 17-year-old man. After excision, histomorphological analysis, and wound closure of a chronic unstable scar in the right popliteal region, a basal cell carcinoma was diagnosed accidentally. A malignancy was not suspected, although the patient already had biopsies, multiple trials of debridement, and skin grafting earlier elsewhere. While an initial attempt to close the defect with a microsurgical flap was abandoned, due to microvascular irregularities, a wound closure was achieved with a free skin graft. The postoperative histomorphologic analysis revealed the surprising diagnosis of a basal cell carcinoma, fortunately with free margins. At follow-up 1 year later, the grafted area was stable, and there was no recurrent disease. A preoperative histomorphologic analysis of the complete excised chronic wound, especially in known skin disorders-regardless of young age-is mandatory. Furthermore, the presented case showed that an abnormal deposition of collagen, and enhanced coprostasis with migration of granulocytes, destroys the normal consistency of small vessels and presents a limitation for microsurgical procedures in these patients.