A 54-year-old man of Turkish descent and skin type III observed 2 progressing lesions at his right and left temporal scalp. Fifteen years earlier he had received cobalt-60 retrobulbar radiation therapy for Graves ophthalmopathy (GO) symptoms, including diplopia, eyelid retraction, and altered ocular motility. The clinical examination revealed 2 symmetrically distributed lesions of asymmetrical shape and gray-brown color (Figure 1A-D). The lesion at the right temple had a palpable patchlike appearance with a few scales, while the lesion at the left temple showed a central ulceration and branched pigmented streaks. Dermoscopy revealed diagnostic features of pigmented basal cell carcinoma (BCC) (Figure 1E and F).1 After complete excision, the diagnosis of 2 pigmented nodular BCCs was confirmed by histopathologic analysis (Figure 2).
Haenssle HA, Richter A, Buhl T, Haas E, Holzkamp R, Emmert S, Schön MP. Pigmented Basal Cell Carcinomas 15 Years After Orbital Radiation Therapy for Graves Ophthalmopathy. Arch Dermatol. 2011;147(4):511-512. doi:10.1001/archdermatol.2011.74