Department of Dermatology, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Department of Dermatology, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
BMJ Case Rep. 2024 Sep 25;17(9):e261362. doi: 10.1136/bcr-2024-261362.
The most common form of primary skin cancer is basal cell carcinoma (BCC). Pigmented BCC is a less common clinical presentation in BCC spectrum, where the tumour contains pigment. Some cases can exhibit morphological features that mimic those of nodular melanoma (NM). We present a woman in her late 40's who had an asymptomatic firm, hyperpigmented nodule on the right cheek resembling pigmented NM. Dermoscopy showed diffuse hyperpigmentation with irregular shiny surface and a solitary haemorrhagic crust. Melanoacanthoma and irritated seborrheic keratosis were the other differentials considered. Punch biopsy showed features of trichoepithelioma initially, subsequent complete excision was suggestive of pigmented BCC.Mortality related to BCC is rare, whereas NM is aggressive. Hence, clinicians need to be aware of this rare presentation of BCC as a hyperpigmented nodule, particularly in dark-skinned individuals. Timely differentiation between melanoma and BCC is crucial given their differing prognosis.
最常见的原发性皮肤癌是基底细胞癌（BCC）。色素性 BCC 是 BCC 谱中较为少见的一种临床表现，其中肿瘤含有色素。某些病例可能表现出类似于结节性黑色素瘤（NM）的形态特征。我们报告了一位 40 多岁的女性，她的右脸颊有一个无症状的坚实、色素沉着的结节，类似于色素性 NM。皮肤镜检查显示弥漫性色素沉着，表面不规则有光泽，并有单个出血性痂。黑素棘皮瘤和刺激性脂溢性角化病也被认为是其他鉴别诊断。皮肤活检最初显示毛上皮瘤的特征，随后的完全切除提示为色素性 BCC。与 BCC 相关的死亡率很少见，而 NM 则具有侵袭性。因此，临床医生需要意识到这种罕见的色素沉着性 BCC 表现为色素沉着性结节，尤其是在深色皮肤个体中。鉴于黑色素瘤和 BCC 的预后不同，及时区分两者至关重要。
