Basal cell carcinoma
There is a lesion in the lower lid (much commoner than the upper lid) which is nodular with an ulcerated centre. The surface is pearly and has telangiectasia. Sometimes, the lesion may present as morphea or sclerosing form.
- check if the lesion is attached to the underlying structure by gently moving the lesion
- check if the puntum is involved (if present, there is a potential risk of orbital extension)
- look for loss of eyelashes (this is indicative of malignancy if the nature of the lesion is uncertain)
- assess the amount of skin skin laxity which would be important in reconstructive surgery
- look for other ocular signs as basal cell carcinoma is unlikely to form the main physical sign in the examination.
1. What is the differential diagnosis of basal cell carcinoma?