A 20-year misdiagnosis: a rare presentation of a basal cell carcinoma

Basal cell carcinoma (BCC) is the most common form of skin cancer. BCCs are seldom reported on the sole of the foot due to a lack of exposure to UV radiation which is the main risk factor. We present a brief literature review and case report of a 42-year-old female with a non-resolving lesion on the mid-arch of her left foot over a 20-year period. Tissue diagnosis identified the lesion as a BCC. Disease-free control was achieved but the patient experienced significant morbidity resulting in three separate procedures to diagnose, excise and reconstruct the defect. When evaluating lesions on the sole clinicians should consider BCC as a differential, particularly in those which do not respond to initial treatment.