Pigmented Basal Cell Carcinoma

A 55-year-old man, phototype IV in Fitzpatrick scale, presented with a 5-year history of a slowly extending papule of the nose. The physical examination revealed a 7-mm, well-defined, black papule with a hyperkeratotic surface was observed, and a differential diagnosis between seborrheic keratosis, angioma, angiokeratoma, basal cell carcinoma (BCC), and nodular melanoma was considered (Figure 1). On dermoscopy, the lesion showed leaflike areas, white shiny lines, rosettes, white veil and scales (Figure 2). Based on the dermoscopic features, the diagnosis of a pigmented nodular BCC was taken into consideration, and the lesion was therefore excised. The histopathological study confirmed the diagnosis of nodular BCC (Figure 3). Dermoscopy is a noninvasive diagnostic tool useful for BCC diagnosis.