Basisquamous cell carcinoma

History

        An 83-year-old woman with an atrophic bald scalp started to develop many red patches with peripheral black dotty pigmentation of more than one year duration. Later on many ulcers arose within these patches. The biggest ulcer was at the parietal area of the scalp. This ulcer was covered with heaped up friable and hemorrhogic crusty material. Many firm to hard non tender lymph nodes were palpated in the head and neck region. The strange and interesting thing in this case was the lesions clinically start as pigmented BCC and later on they took a SCC-like morphology. Histopathology of many biopsies (early and late lesions) showed basisquamous cell carcinoma.