Pilomatrix Carcinoma Mimicking a Pigmented Basal Cell Carcinoma

A 76-year-old Caucasian man presented to the dermatology clinic for evaluation of a growing lesion in his right preauricular area. He first noticed the lesion several months prior to presentation but felt it had enlarged significantly in the past month. He denied any pain, pruritus, or bleeding. His medical history was significant for melanoma of the nose treated 47 years ago, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, and chronic back pain. The patient reported having the melanoma treated but was unaware of any other details concerning the lesion. He denied any allergies and his medications included lisinopril, amlodipine, gabapentin, and budesonide.