The lesions shown in the illustrations are from the forehead of a 77-year-old man (case 1, Figure 1), the temple of an 83-year-old man (case 2, Figure 2), and the clavicle of a 26-year-old woman (case 3, Figure 3). All 3 patients had prior basal cell carcinomas in these locations that had been treated with excision (cases 1 and 2) or photodynamic therapy (case 3). The original tumors were not noted to be pigmented. In these 3 cases, the first sign of early relapse was the presence of brown-gray pigmented foci that revealed ovoid-globular structures (arrows, Figures 1 through 3) on dermoscopic examination. Histologically, the brown-gray structures corresponded to tumoral nests at the dermoepidermal junction (Figure 4). The brown-gray coloration presumably resulted from local increases in melanin caused by recurrent tumor at the dermoepidermal junction. These brown-gray structures may be an important clue for detection of the early relapse of some basal cell carcinomas.
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Case 1. Clinical (inset) and dermoscopic views.
Case 2. Clinical (inset) and dermoscopic views.
Case 3. Clinical (inset) and dermoscopic views.
Histologic image showing brown-gray foci (hematoxylin-eosin, original magnification ×60).
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