Unusual presentation of basal cell carcinoma: Beyond the face

Basal cell carcinoma (BCC) is the most common type of nonmelanoma skin cancer. It is commonly seen in fair-skinned individuals over sun-exposed areas. BCC typically appears as pearly pink or flesh-colored papules with telangiectasia. It is slow-growing and locally invasive. Pigmented BCC is extremely rare, accounting for only 6% of the cases. The lower extremities are the areas most unlikely to develop the lesion as they are not exposed to sunlight. There are a few isolated case reports describing pigmented BCC of lower extremities. In most cases of primary BCC, surgery is the preferred treatment.