Basal Cell Carcinoma of Hand Presenting With Severe Sepsis

Basal cell carcinoma (BCC) is one of the most common skin malignancies in the United States. It commonly presents in the neck and head as a papulo-nodular lesion that is slow-growing with rare metastasis. BCC has a high curative rate often with Mohs surgery or excision of the lesion. In this case, we present an 80-year-old male who presented to the emergency department with a necrotizing wound on his left hand and met sepsis criteria. His necrotizing wound was identified as severe BCC of his hands which he has a 10-year history diagnosis of. He received appropriate sepsis measures with fluids, antibiotics, and blood transfusions but denied any further care for his BCC. Our case is unique because hands are an extremely uncommon presentation location of BCC. It is also unique because he presented as an extremely aggressive case while most cases of BCC are relatively innocuous. Early management of BCC is important, especially with a multidisciplinary approach as it can significantly reduce mortality risk.