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Case of the Month

pigmented basal cell pathology 50X

A 73-year-old Native American woman with a dark lesion that appeared and has progressed over 3 years on her central forehead. The lesion started bleeding with minor trauma about 3 months ago.

Here is the pathology, kindly provided by Erick Jacobson-Dunlop, MD, Board Certified Dermatopathologist, (Minneapolis Minnesota)

pigmented basal cell pathology 50X
Dermatoscopic view
pigmented basal cell pathology 100X
50X microscopic view

What's Your Diagnosis?

Diagnosis: Pigmented Basal Cell Carcinoma

Pigmented basal cell carcinoma is a clinical and histological variant of basal cell carcinoma that exhibits increased pigmentation. It is a very rare variant, although its frequency, reportedly, can reach up to 6% of total basal cell carcinomas in Hispanics and Asians. I have several colleagues who practice dermatology in the southwestern United States and they tell me that they believe the incidence of pigmented basal cell skin cancers in Asian and Hispanic patients to actually be much higher than 6%. The clinical photograph demonstrates the translucent rolled border and central ulceration. If you look closely at the dermatoscopic view, you can see telangiectasias (angiogenesis) at approximately the 2:00 position.

References A Clinical Atlas of 101 Common Skin Diseases

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Charles Crutchfield III M.D. Eagan Dermatologist

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