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Tinea Capitis Masquerading as Basal Cell Carcinoma.

Hubert M Chodkiewicz1,2, Jennifer Song Ranario2, Richard Jahan-Tigh3

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A patient with alcoholic cirrhosis presented with scalp bumps initially diagnosed as basal cell carcinoma. Further evaluation in a Mohs surgery clinic was sought for accurate diagnosis and treatment planning.

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Area of Science:

  • Dermatology
  • Oncology
  • Hepatology

Background:

  • Alcoholic cirrhosis is a chronic liver disease associated with various complications.
  • Cutaneous manifestations can occur in patients with advanced liver disease.
  • Accurate diagnosis of scalp lesions is crucial for appropriate management.

Observation:

  • A 52-year-old man with alcoholic cirrhosis presented with a month-long history of tender scalp bumps.
  • Previous biopsies from an outside institution were interpreted as basal cell carcinoma and actinic keratosis.
  • The patient was scheduled for extensive scalp excision based on these preliminary diagnoses.

Findings:

  • The patient sought a second opinion at a Mohs surgery clinic due to the presumed diagnosis of multiple basal cell carcinoma nodules.
  • The presentation prompted a need for definitive diagnostic confirmation and surgical planning.

Implications:

  • This case highlights the importance of thorough evaluation for scalp lesions in patients with underlying systemic conditions like alcoholic cirrhosis.
  • Accurate histopathological diagnosis is essential to avoid unnecessary extensive surgical procedures.
  • Mohs surgery offers precise management for complex cutaneous oncological cases.