Clinical image: an unusual pigmented basal cell carcinoma arising from vulva.

Basal cell carcinoma (BCC) is the most common human malignancy. It occurs most often in elderly patients on the sun-exposed skin of the head and neck (1). ma skin cancer and is uncommon on unexposed skin such as the genital and perianal region (2). We report a 78-year-old otherwise healthy woman that was seen with a pigmented lesion originating on the right vulva. The lesion had started as a small macula 20 years ago. It later became pigmented and extensive and transformed into a large, neglected pigmented patch on the right side of the vulva. Physical examination was notable for a 2 × 4 cm, well-demarcated and pigmented patch on the right labium majus. A biopsy specimen was obtained and the lesion was diagnosed histopathologically as a pigmented basal cell carcinoma. The patient underwent a wide radical local excision and ipsi-