Basal cell carcinoma

Can you identify this erythematous lesion?

DAVID L. KAPLAN, MD—Series Editor: Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

Volume 52 - Issue 12 - December 2012

basal cell carcinoma

This solitary, nonresolving erythematous lesion has been present on the mid thigh of a 73-year-old woman for several months. She reports that the lesion is asymptomatic, has not changed in size, and has never bled.

What do you suspect?

A. Irritated seborrheic keratosis.
B. Basal cell carcinoma.
C. Squamous cell carcinoma.
D. Bowen’s disease, or squamous cell carcinoma in situ.
E. Amelanotic melanoma.

(Answer on next page.)

basal cell carcinoma


Answer: Bowen’s disease, or squamous cell carcinoma in situ

All of the diagnoses in the differential are reasonable based on the history and appearance of the lesion. A biopsy of the site revealed Bowen’s disease, or squamous cell carcinoma in situ, D.

Often arising on sun-exposed areas or in persons who have been exposed to arsenic, Bowen’s plaques can be removed by simple curettage and electrodesiccation. In this case, such treatment was curative. Follow-up is important because recurrences are fairly common. Failure to remove the lesion may result in invasive carcinoma.