Pigmented basal cell carcinoma: Case report

Abstract

Basal cell carcinoma (BCC) is the most common malignancy in humans and its incidence has been increasing in recent decades. Pigmented basal cell carcinoma is a clinical and histological variant of BCC, characterized by brown or black pigmentation, comprising only 6% of the total of CBCs. Report a case of pigmented BCC in the left malar region presented as an atrophic plaque. Emphasize the importance of dermatoscopy in the physical examination of the skin in every health service, as well as compare the results with those reported in the medical literature. 71-year-old male patient, phototype II. On physical examination, he presented a brownish-gray atrophic plaque with a pearly surface and blackened area, measuring approximately 1 cm, located in the left malar region. The patient's clinic and dermatoscopy were suggestive of pigmented BCC, but the lesion was neither nodular nor superficial, being different from what was found in the literature. An excisional biopsy of the lesion with a free margin and diagnostic confirmation was performed. Adequate treatment and follow-up was instituted. Anamnesis and physical examination combined with dermatoscopy were essential to determine the diagnosis and guide the conduct to be followed in the case reported. Because the clinical presentation of the lesion can raise doubts, since it does not have the most frequent presentation of BCC.