Abstract
Basal cell carcinoma may present as a discrete skin-colored papule, which may mimic other common skin tumors. We present pigmented speckling as a clinical sign for basal cell carcinoma. Twenty cases of basal cell carcinoma with pigmented speckling were collected and their clinical and histologic features were reviewed. There were 12 men and 5 women. The patients' average age was 70.5 years (range 33-90 years). Fifteen of the 17 tumors were on the head and neck, and 2 tumors were on the shoulders and back. Clinical examination revealed a "speckled appearance" of brown-black pigmentation within and/or at the border of the tumors. Histopathology showed basal cell carcinoma with melanin pigment (positive for Fontana-Masson stain and negative for Perl's stain) within nests of tumor cells. The speckled pigmentation of a basal cell carcinoma is a distinguishing feature, which may be useful in the differential diagnosis of this tumor from other discrete skin tumors.
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