Abstract

Basal cell carcinoma (BCC) is the most common type of malignancy and incidence is steadily increasing, partially due to the impact of cumulative sun exposure and a longer-living population.1  Most BCCs occur in areas of the skin that have chronic exposure to the sun, like the face, arms, and neck. If left untreated, BCC can become locally invasive and result in destruction of skin, tissue, and bone. A 91 year old female presented for evaluation of a bleeding, irregular, non-healing skin plaque on her right hand that had been present for 5 years. The palmar plaque was persistently itchy, which caused the patient to scratch it leading to tenderness. The plaque had previously been diagnosed as hand dermatitis, eczema, and was treated with topical corticosteroids for 5 years. A deep shave biopsy of the palmar lesion confirmed BCC with nodular and infiltrative features. The patient was referred to Mohs micrographic surgery and was cleared after 2 stages. The way this patient's BCC was mimicking eczema is a unique and rare aspect of this case. The lesion was persistently itchy which is similar to how eczema presents. We recommend physicians to be aware of BCC arising in rare sites like the palm, recognize that BCC may mimic eczema, and have an index of suspicion to biopsy scaly, long-standing plaques that fail to respond to therapy.

Presented at American Muslim Medical Student Association National Conference, Ann Harbor, Michigan 2022

Accepted for Electronic Poster Display at 25th World Congress of Dermatology, Singapore 2023

Submitted to Cureus Journal of Medical Science