morpheaform or sclerosing basal cell carcinoma

Introduction

Infiltrating form of BCC with an excessive amount of fibrous stroma appearing as a scar.

Epidemiology

4-17% of basal cell carcinomas

Pathology

• clinically more aggressive form of basal cell carcinoma
• micronudular, infiltrative skin neoplasm

Clinical manifestations

• flat, indurated, whiteish macules with ill-defined borders
• pigmentation & telangiectasias may be seen
• finger-like extensions of tumor often extend far into surrounding tissue, neccessitating wide surgical margins
• lesions often resemble a scar, but without history of previous trauma to that area
• lesions generally do not ulcerate until late

Differential diagnosis

• cicatrix (scar)
• localized scleroderma
• morphea

More general terms

• basal cell carcinoma (BCC)