Basal cell carcinoma of the sole

Clinical and dermoscopic features of Fibroepithelioma of Pinkus: case series with an emphasis on hypopigmented to pink lines intersecting at acute angles

Fibroepithelioma of Pinkus (FEP) is a subtype of basal cell carcinoma (BCC) that can clinically resemble intradermal nevi (IDN) and fibromas. We performed a retrospective review of consecutively biopsied lesions confirmed to be FEP on histopathology diagnosed from January 1, 2008 to April 8, 2019. Clinical (n = 48), contact non-polarized dermoscopy (NPD) (n = 44), and contact polarized dermoscopy (PD) (n = 22) images from 36 patients were reviewed. Mean age was 64.5 years (SD 15.1 years, range 24-86 years) at diagnosis of first FEP lesion. Most lesions were located on the torso (n = 28, 58.3%), followed by the lower extremity (n = 9, 18.8%). The most common differential diagnoses at the time of biopsy included BCC (n = 40) and nevus (other than IDN, n = 5). Clinically, FEP were pink (95.8%), scaly (66.7%) papules (77.1%) displaying disrupted skin markings (62.5%) and absence of hair follicles (87.5%). NPD revealed serpentine (97.7%), dotted (81.8%), or polymorphous vessels (86.4%), and hypopigmented to pink lines intersecting at acute angles (HPLA) (52.3%). PD demonstrated serpentine (95.5%), dotted (86.4%), or polymorphous vessels (81.8%), shiny white lines (50.0%), and HPLA (59.1%). Classic features of BCC such as arborizing vessels (n = 2), ulceration (n = 1), shiny white blotches and strands (n = 1), blue-gray ovoid nest (n = 1), and leaf-like areas (n = 1) were uncommon. FEP often presents as scaly, erythematous papules with disrupted skin markings and absence of hair follicles. Dermoscopy reveals polymorphous vessels with shiny white lines and HPLA.

A Case Report of Basal Cell Carcinoma in a Non-Sun-Exposed Area: A Rare Presentation Mimicking Recurrent Perianal Abscess

Basal cell carcinoma (BCC), a common malignancy, arises most often in sun-exposed areas but does rarely occur in non-sun-exposed sites. Prior tissue injury, especially sharp trauma and chronic inflammation, increases the risk of BCC. We describe a 66-year-old male patient with recurrent perianal abscesses who was found to have a large pigmented basal cell carcinoma. The mass was excised without recurrence at two-year follow-up. Perianal BCC is commonly larger at the time of diagnosis than tumors in sun-exposed sites, likely related to delay in diagnosis. Increased size can lead to increased surgical complexity and more pronounced effects on nearby structures. Early detection is important for optimal patient outcomes. In selected patients presenting with a perianal mass, basal cell carcinoma should be included on the differential diagnosis.

Basal Cell Carcinoma of the Dorsal Foot: An Update and Comprehensive Review of the Literature

BACKGROUND

Ultraviolet radiation is a well-known risk factor for basal cell carcinoma (BCC). Therefore, the high incidence of BCCs in sun-exposed areas such as the head and neck is unsurprising. However, unexpectedly, BCCs on the sun-protected dorsal foot have also been reported, and tumor occurrence here suggests that other factors besides ultraviolet radiation may play a role in BCC pathogenesis. Because only few dorsal foot BCCs have been reported, data on their clinical features and management are limited.

OBJECTIVE

To perform an updated review of the literature on clinical characteristics and treatment of dorsal foot BCCs.

METHODS

We conducted a comprehensive literature review by searching the PubMed database with the key phrases "basal cell carcinoma dorsal foot," "basal cell carcinoma foot," and "basal cell carcinoma toe."

RESULTS

We identified 20 cases of dorsal foot BCCs in the literature, 17 of which had sufficient data for analysis. Only 1 case was treated with Mohs micrographic surgery. We present 8 additional cases of dorsal foot BCCs treated with Mohs micrographic surgery.

CONCLUSION

Basal cell carcinomas on the dorsal foot are rare, and potential risk factors include Caucasian descent and personal history of skin cancer. Mohs micrographic surgery seems to be an effective treatment option.

Fibroepithelioma of Pinkus Revisited

Background

Fibroepithelioma of Pinkus (FeP) is considered a variant of basal cell carcinoma (BCC); however, in the past 20 years, some researchers have argued for its classification as a trichoblastoma. Recently, use of a new immunostaining marker and further dermoscopic characterization of FeP have advanced the debate about its proper classification.

Purpose

A review of the evidence for and against classification of FeP as BCC or trichoblastoma is presented.

Methods

Using PubMed, the term FeP was searched and relevant citations were assessed. Additional relevant articles were identified from references of key papers.

Results

FeP shares characteristics of both trichoblastoma and BCC.

Conclusion

Derived from the same cell type, BCC and trichoblastoma may be best considered as representing opposite ends of a spectrum of differentiation, with FeP deserving an intermediate classification.

Basal Cell Carcinoma of the Sole

We report a case of a 72-year-old woman with a two year history of a plantar lesion. The clinical appearance, a nodular reddish irregular mass about 2 centimeters in diameter, suggested a tumoral lesion. Histologic examination revealed a basal cell carcinoma. The lesion was excised with no recurrence after two years of follow up. The clinical events, and the histological findings are briefly discussed.

Vulvar basal cell carcinoma: retrospective study and review of literature

OBJECTIVES

Basal Cell Carcinoma (BCC) is the most common human malignant neoplasm. It does not occur only in anatomical areas commonly exposed to sunlight, but also in relatively protected body sites such as the axillae, the groin and buttocks, and in regions which are entirely protected from the sun, like the vulva. The aim of this study is to assess the impact and clinical features of BCCs in the vulva versus other anatomical sites.

METHODS

For this purpose, we retrospectively reviewed all the histological diagnoses of BCCs made between 1995 and 2003 in the Department of Human Pathology and Oncology of the University of Florence, Italy.

RESULTS

Out of 3604 cases of BCC, 63 were in the vulva. The average age of patients suffering from the latter was 70.35 years. The average size of the vulvar BCCs was 2.1 cm and 18 (28%) were ulcerated at presentation.

CONCLUSIONS

Our study shows that vulvar BCC is not a particularly rare occurrence; in fact it should be suspected whenever lesions that we believe to be inflammatory do not respond to usual treatment. In our experience, mucocutaneous examination of this anatomical area should be performed especially in patients with a history of skin cancer. In case of suspicion, a biopsy is recommended to obtain a preoperative confirmatory diagnosis.

Atypical Presentation of Metastatic Basal Cell Carcinoma

Basal cell carcinoma is an indolent, slow-growing tumor that rarely metastasizes. Approximately 70% of tumors occur in the head and neck regions. If a basal cell tumor metastasizes, it usually spreads to the regional lymph nodes first, followed by the lungs. We describe a patient with basal cell carcinoma of the right lower extremity with skin metastases. Skin biopsy of one tumor revealed fibroepithelioma of Pinkus, a rare variant of basal cell carcinoma.

Basal cell carcinoma on the right hallux

Basal cell carcinomas (BCCs) usually develop in sun-exposed areas. The finger, toe, and nail unit are very rare sites of BCC. We describe a patient with BCC on the right hallux. Clinically, it appeared as a brown-colored small plaque with an irregular border on the nail fold and dorsum of the right hallux. Histopathological findings were consistent with the superficial type of BCC.