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Pigmented basal cell carcinoma mimicking nodular melanoma
Manila Purushottama1, Shankar Bharathi Ashwini1, Poovanur Sadasivam Subramanian Ranugha2
1Department of Dermatology, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
BMJ Case Reports
|September 25, 2024
Summary
This study highlights a rare, pigmented basal cell carcinoma (BCC) that mimics nodular melanoma (NM). Early differentiation is crucial for patient prognosis due to the differing nature of these skin cancers.
Area of Science:
- Dermatology
- Oncology
Background:
- Basal cell carcinoma (BCC) is the most common skin cancer.
- Pigmented BCC, a less common variant, can present with features mimicking nodular melanoma (NM).
Observation:
- A case of a pigmented nodule on the cheek of a woman in her late 40s is presented.
- The lesion was asymptomatic, firm, and hyperpigmented, resembling pigmented NM.
- Dermoscopy revealed diffuse hyperpigmentation with an irregular shiny surface and a hemorrhagic crust.
Findings:
- Differential diagnoses included melanoacanthoma and irritated seborrheic keratosis.
- Initial punch biopsy suggested trichoepithelioma.
- Complete excision confirmed the diagnosis of pigmented basal cell carcinoma.
Implications:
- Awareness of this rare pigmented BCC presentation is vital for clinicians, especially in dark-skinned individuals.
- Accurate differentiation between melanoma and BCC is critical due to their vastly different prognoses and treatment strategies.
- Timely diagnosis can prevent misclassification and ensure appropriate management of potentially aggressive skin lesions.
