60 yr old male, gradual onset(6-8 months) lesion over the nasal ala, painless, no intranasal extension, no cervical lymphadenopathy. How would you proceed and what are your probable diagnoses?

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looks like basal cell ca biopsy for conf. then further Tt.

Any tumor or growth ,long standing & no pain always suspect malignancy. That's why pt reports late with late diagnosis & late Tt after disease has progressed far more
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bcc confirmation by biopsy Rx. Excision by 0.5. cms healthy margin followed by reconstruction.

Dr Indranil If not Bcc Then a variant of BCC, 1.Fibroepithelioma of Pinkus 2.Keratoacanthoma (molluscum sebaceum)

Probably the case infected sebaceous cyst. rx excision. .

It is easy for me to disagree as i already operated on the patient. But the purpose behind my post is the surprising diagnosis which I admit never occured to me as well.
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Rodent ulcer (BCC)

Biopsy indeterminate- pathologist asked for more tissue. Excised it with local flap recon. HPE with IHC revealed a variant of T Cell Lymphoma. PAtient is now under Medical Oncologist.

Looks like BCC. Pls get a biopsy done

Clinical appearance is like bcc. do a biopsy, confirm and if so excise. also reconstruct. many local advancement flaps available

What's the hpe report

Melanotic lesion ADVISED BIOPSY

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