(BMJ)—A 92-yo man w/ hx of chronic renal impairment complained of a lesion on his R nostril that had been present for 10+ yrs and had recently enlarged. Exam: 10-mm pink, pearlescent, pedunculated nodule w/ telangiectasia, arising from R nasal ala. What is the dx?
Intradermal nevus
Basal cell carcinoma
Seborrheic keratosis
Actinic keratosis
Sebaceoma
You are correct. Clinical appearance was characteristic of basal cell carcinoma (BCC), and bx confirmed the dx. Hx of slow growth makes squamous cell carcinoma or sebaceous carcinoma less likely. DDx of nodular BCC includes the other choices listed. Tx is surgical excision or radio-tx. The pt underwent Mohs surgery w/ subsequent reconstruction of the ala. Three-mo f/u revealed a good cosmetic result, w/ no evidence of recurrence.

BMJ 2017;356:j763
By vgreene, 18 May, 2017

NOF