Is this pearly papule cause for concern?

May 5, 2010

During a routine skin examination, a papule of several years’ duration is noted on the upper lip of a 71-yearold man. The patient states that the lesion has been slowly enlarging; it does not bleed even during shaving.

Case:

During a routine skin examination, a papule of several years' duration is noted on the upper lip of a 71-year-old man. The patient states that the lesion has been slowly enlarging; it does not bleed even during shaving.

What does this look like to you?

A. Basal cell carcinoma.
B. Squamous cell carcinoma.
C. Seborrheic keratosis.
D. Melanocytic nevus.
E. Wart.

 

Answer on Next Page

Case: Basal cell carcinoma

The pearly, translucent papule suggested a skin cancer. A biopsy confirmed the clinical impression of basal cell carcinoma (BCC), A. Squamous cell carcinomas usually are more nodular and have a keratotic core. Seborrheic keratoses typically have a pasted-on appearance and feature identifiable keratin plugging. Intradermal nevi are not translucent and do not contain the telangiectasia often seen in BCC. Generally, BCCs bleed easily; however, this one did not. The lesion was excised successfully.

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