Mixed type basal cell carcinoma: Clinical correlation of dermoscopy and histopathology

Abstract

Abstract

Introduction: Basal cell carcinoma (BCC) is a skin cancer that arising from the basal layer of the epidermis. If left untreated, it may cause significant tissue destruction and morbidity. The gold standard for diagnosing BCC involves clinical examination, dermoscopy, and histopathology. Mixed-type BCC poses particular challenges due to its aggressive behavior and higher recurrence risk. Case report: A 56-year-old Caucasian male presented with a gradually enlarging lump on his forehead over the past year. Clinical examination revealed a pigmented nodule (6.5 × 9 × 4 mm) on the temporalis dextra. Dermoscopy features including blue-gray ovoid nests, arborizing telangiectasias, and blue-gray globules were found. Complete excisional biopsy confirmed mixed-type BCC. Discussion: Ultraviolet light exposure plays an important role in the development of BCC, in addition to genetic predisposition factors. The patient had Fitzpatrick skin type II with occupational sun exposure as a significant risk factor. Dermoscopy enhanced the preliminary diagnosis, revealing characteristic features including blue-gray ovoid nests, arborizing telangiectasias, and blue-gray globules, which correlated with histopathological findings. In this case, mixed type BCC (aggressive type) was confirmed through histopathological examination following complete excisional biopsy. Conclusion: The accurate diagnosis of BCC requires integration of clinical examination, dermoscopy, and histopathology. Dermoscopy enables early detection while histopathology remains the gold standard for definitive diagnosis and risk stratification. In this case, mixed-type BCC poses particular challenges due to its aggressive behavior and higher recurrence risk, which requires complete excision.

Keywords : Mixed Type BCC, Dermoscopy, Histophatology