Basal cell carcinoma of the lower leg occurring in association with chronic venous stasis

A patient with basal cell carcinoma found within a chronic venous stasis ulcer of the lower leg is reported, and the literature is reviewed. Basal cell carcinomas found within venous stasis ulcers tend to be multifocal and of the sclerosing type. Tumors often extend into the reticular dermis but have never been reported to extend deep to subcutaneous tissue. The plastic surgeon should familiarize himself with these entities when dealing with what appears to be chronic nonhealing venous stasis ulcers. Such ulcers warrant an incisional biopsy. Once a diagnosis of basal cell carcinoma is made, excision of the lesion down to the underlying muscle fascia and coverage with a split-thickness skin graft is usually curative. Because of the multifocal nature of these lesions, all other suspicious or hyperpigmented lesions of the leg should also be biopsied.