Basal Cell Carcinoma on Face of a 75-Year-Old Woman

A 75-year-old Hispanic woman presented with a slowly growing, asymptomatic facial lesion of about 3 years' duration.

Physical examination disclosed a 6.5 × 4.5-cm, irregularly shaped plaque that involved both the pinna and preauricular skin. The lesion had a prominent rolled border; multiple discrete, darkly pigmented nodules; and central regression with fibrosis. A biopsy revealed nests of typical basal cell carcinoma with massive deposition of melanin within the tumor cells. The tumor was removed using Mohs microscopic surgery.

Dr Ted Rosen of Houston writes that basal cell carcinoma can sometimes simulate melanoma and manifest unusual coloration on dark-skinned persons.

FOR MORE INFORMATION:

• Kalter DC, Goldberg LH, Rosen T. Darkly pigmented lesions in dark-skinned patients. J Dermatol Surg Oncol. 1984;10:876-881.