The smooth and translucent nature of this nodule suggests the correct diagnosis: basal cell carcinoma.
A 47-year-old man notes the recent onset of an asymptomatic lesion located on the upper arm. He has been employed as a construction worker in Houston for several decades and denies the use of sunscreen.
Key point: The smooth and translucent nature of this nodule suggests the correct diagnosis: basal cell carcinoma. There is some heavy pigmentation to the lesion which might, justifiably, suggest a diagnosis of melanoma.
Treatment: The lesion was excised with a 5 mm margin of normal skin. Histologic analysis of the specimen confirmed clear peripheral and deep margins.
Note: Basal cell carcinoma can be variably pigmented, especially when the patient’s skin tone is dark. This patient was Hispanic. When there is doubt about the diagnosis, a small biopsy would be in order to make sure the proper excisional margins are being observed. Before the definitive excision, a 2-mm punch biopsy was performed to exclude the diagnosis of melanoma.
Atopic Dermatitis: The Pipeline and Clinical Approaches That Could Transform the Standard of Care
September 24th 2025Patient Care tapped the rich trove of research and expert perspectives from the Revolutionizing Atopic Dermatitis 2025 conference to create a snapshot of the AD care of the future.