A 65-year-old multiparous white woman was referred to our clinic with a large erythematous lesion on the vulva featuring partially pigmented areas. The case history revealed that the patient had been aware of the lesion for about 1 year and that the lesion had been treated unsuccessfully for some time with topical corticosteroid therapy following diagnosis as eczema. The lesion had grown progressively larger, causing troublesome itching.
On clinical examination, an erythematous lesion, approximately 3 × 2 cm, was found on the right labium minor and also involving the base of the clitoris. The lesion was asymmetric with irregular and ill-defined borders. Partial pigmentation was irregularly located, with gray-blue color at the periphery. The lesion was barely palpable, with slightly raised borders (Figure 1). Dermoscopic examination revealed the presence of telangiectasias and blue ovoid nests, which, in the absence of melanocytic dermoscopic parameters such as pigmented network, brown globules, and pseudopods, allowed us to formulate the diagnosis of basal cell carcinoma (BCC) (Figure 2).
de Giorgi V, Massi D, Mannone F, Checcucci V, De Magnis A, Sestini S, Papi F, Lotti T. Dermoscopy in Vulvar Basal Cell Carcinoma. Arch Dermatol. 2007;143(3):423-431. doi:10.1001/archderm.143.3.426