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September 15, 2008

Dermoscopy of Early Recurrent Basal Cell Carcinoma

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Arch Dermatol. 2008;144(9):1254. doi:10.1001/archderm.144.9.1254

The lesions shown in the illustrations are from the forehead of a 77-year-old man (case 1, Figure 1), the temple of an 83-year-old man (case 2, Figure 2), and the clavicle of a 26-year-old woman (case 3, Figure 3). All 3 patients had prior basal cell carcinomas in these locations that had been treated with excision (cases 1 and 2) or photodynamic therapy (case 3). The original tumors were not noted to be pigmented. In these 3 cases, the first sign of early relapse was the presence of brown-gray pigmented foci that revealed ovoid-globular structures (arrows, Figures 1 through 3) on dermoscopic examination. Histologically, the brown-gray structures corresponded to tumoral nests at the dermoepidermal junction (Figure 4). The brown-gray coloration presumably resulted from local increases in melanin caused by recurrent tumor at the dermoepidermal junction. These brown-gray structures may be an important clue for detection of the early relapse of some basal cell carcinomas.

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