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Histopathologic examination of the biopsy specimen demonstrated many tumor nests with a peripheral palisading arrangement in the upper and middle dermis. The tumor cells were small and had indistinct cytoplasmic borders and oval, basophilic, vesicular nuclei. These histopathologic findings were consistent with BCC. The patient and her family refused any further examinations and therapy, probably because of her age.
Basal cell carcinoma, which is the most common malignant neoplasm of the skin, commonly arises on the face. Ono1 found that 85% of BCCs in ethnic Japanese patients are pigmented and therefore require differentiation from malignant melanoma. Clinical diagnosis is not difficult in cases of BCC in which the tumor shows the typical black appearance, but in cases involving a nonpigmented BCC on an unusual site, the diagnosis is likely to depend on the findings of histologic examination.
Erosive Velvety Lesion on the Vulva—Diagnosis. Arch Dermatol. 2006;142(3):385-390. doi:10.1001/archderm.142.3.385-g