Dermatology: Practical and Conceptual


Dermatology Practical & Conceptual

Image Letter | Dermatol Pract Concept. 2022;12(1):e2022028 1

Basal Cell Carcinoma Disguised Among  
Intradermal Nevi

Gabriel Salerni1,2

1 Dermatology Department, Hospital Provincial del Centenario de Rosario - Universidad Nacional de Rosario, Argentina

2 Oroño Medical Diagnosis, Rosario, Argentina

Citation: Salerni G. Basal cell carcinoma disguised among intradermal nevi. Dermatol Pract Concept. 2022;12(1):e2022028.  
DOI: https://doi.org/10.5826/dpc.1201a28

Accepted: July 1, 2021; Published: January 2022

Copyright: ©2022 Gabriel Salerni. This is an open-access article distributed under the terms of the Creative Commons  
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted 
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Corresponding author: Gabriel Salerni, MD, PhD, Dermatology Department, Hospital Provincial del Centenario de Rosario - Universidad 
Nacional de Rosario, Argentina; Oroño Medical Diagnosis, Rosario, Argentina. E-mail: gabrielsalerni@hotmail.com

Case Presentation

A 61-year-old woman presented to consultation for routine 

skin examination. Cutaneous examination revealed multiple 

longstanding firms, achromic, dome-shaped, papules, ranging 

from 5 mm to 12 mm in diameter (Figure 1A) located on the 

forehead. The patient was unaware of any change. Dermos-

copy revealed remnants of light brown pigmentation, termi-

nal hairs, comma-like (linear curved) vessels and comedo-like 

openings in lesions a to e (Figure 1B) which were suggestive of 

intradermal nevi. Lesion f displayed dermoscopic criteria for 

basal cell carcinoma consisting of a pink background, arbor-

izing telangiectasias, gray-brown dots, and structureless areas. 

Teaching Point

Dermoscopy improves the diagnosis of non-pigmented skin 

tumors because it allows the visualization of vascular patterns 

and residual pigmentation that are not visible to the naked eye 

[1,2]. In this case, dermoscopy provided crucial information 

for recognition of a basal cell carcinoma that might have 

been overlooked among multiple benign melanocytic lesions 

assessed solely by the naked eye.

Informed consent: Informed consent for publication of 

clinical details and clinical images was obtained from the 

patient.



2 Image Letter | Dermatol Pract Concept. 2022;12(1):e2022028

References

1. Zalaudek I, Kreusch J, Giacomel J, Ferrara G, Catricalà C, Argen-

ziano G. How to diagnose nonpigmented skin tumors: a review 

of vascular structures seen with dermoscopy: part I. Melanocytic 

skin tumors. J Am Acad Dermatol. 2010;63(3):361-74; quiz 

375-6. DOI: 10.1016/j.jaad.2009.11.698. PMID: 20708469.

2. Greco V, Cappello M, Megna M, et al. Dermoscopic patterns of 

intradermal naevi. Australas J Dermatol. 2020;61(4):337-341. 

DOI: 10.1111/ajd.13366. PMID: 32715462.

Figure 1. (A) Multiple firms, achromic, dome-shaped papules, located on the forehead. (B) Dermoscopy revealed criteria for intradermal nevi 

in lesions a to e, while lesion f displayed pink background, arborizing telangiectasias (arrows), gray-brown dots (circle), and structureless 

areas (asterisks) consistent with basal cell carcinoma.