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Morphea-Like Basal Cell Epithelioma.— Presented by Wilbur B. Hurlbut, MD.
The patient is a 78-year-old white woman who first noticed a change in the skin on the tip of the nose about six months ago when she saw a tiny bleeding spot. She has had no x-ray therapy to the face and has avoided sun exposure. Fifty years ago she believes she took arsenic for eczema.
The face shows a number of actinic keratoses. Straddling the end of the nose is a firm, irregular, yellowish white plaque with telangiectases about 2 cm in longest dimension (Figure).
The biopsy specimen shows fibrosis and numerous narrow strands of basal cells extending deep in the cutis. There are relatively few cells in each strand.
Perry Sachs, MD: This is a difficult type of case to treat. The microscopic picture shows a disseminated basal cell epithelioma, arranged in
MANHATTAN DERMATOLOGICAL SOCIETY. Arch Dermatol. 1967;95(3):325-329. doi:10.1001/archderm.1967.01600330083018