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Basal cell carcinoma

How would you treat this erythematous, scaly patch?

DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas_

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, Kansas.   

Volume 52 - Issue 3 - March 2012

basal cell carcinomaDuring a general skin examination, a lesion is noted on the chest of a 44-year-old man. The patient was completely unaware of this erythematous, scaly patch and is unable to provide any history.

Your course of action is to:

A. Wait and watch for the next 3 month.

B. Perform a potassium hydroxide examination.

C. Perform a skin biopsy.

D. Prescribe a topical corticosteroid.

E. Try a topical antibiotic for suspected impetigo.

(Answer on next page)

 

Answer: Basal cell carcinoma

The friable, asymptomatic lesion raised suspicion of cutaneous malignancy. A skin biopsy, C, confirmed the clinical impression of basal cell carcinoma.

Impetigo and ringworm are usually more symptomatic than the lesion seen here. Application of a topical corticosteroid would temporarily improve the appearance . . . and delay the diagnosis.