Pigmented Basal Cell Carcinoma

Diagnosis: Pigmented Basal Cell Carcinoma

Pigmented, raised and beaded margin with central atrophy.

Clinical Presentation

Pigmented, raised and beaded margin with central atrophy.

Clinical History

Submitted by Alaa Saad. Originally posted November 3, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Squamous cell carcinoma • Amelanotic melanoma • Intradermal nevus • Sebaceous hyperplasia • Trichoepithelioma • Merkel cell carcinoma • Dermatofibroma

Key Learnings

• Most common human cancer — accounts for ~80% of non-melanoma skin cancers • Locally destructive but rarely metastasizes (<0.1%) • Classic dermoscopy: arborizing vessels, blue-gray ovoid nests, leaf-like structures, spoke-wheel structures • Subtypes: nodular (most common), superficial, morpheaform/infiltrative (highest recurrence), pigmented • Gorlin syndrome (PTCH1 mutation): multiple BCCs, odontogenic keratocysts, skeletal anomalies • Hedgehog pathway inhibitors (vismodegib, sonidegib) for advanced/inoperable BCC

Tags: pigmented, basal, cell, carcinoma, alaa saad