Peer Reviewed


What Is the Most Likely Diagnosis?

David L. Kaplan, MD—Series Editor

Kaplan DL. A photo quiz to hone dermatologic skills. Consultant. 2018;58(10):272-273. 


This 66-year-old man presented for an annual skin examination and was noted to have a lesion on his lateral trunk that he had been unaware of. It was asymptomatic and of uncertain duration.




Find Out!

Answer: Basal cell carcinoma



A biopsy confirmed the clinical impression of a pigmented basal cell carcinoma. The pigmentation results from the presence of melanocytes and melanin admixed with the tumor cells, so it mimics the other pigmented lesions listed above.

A deep shave removal or excision will confirm the diagnosis if the clinical diagnosis is not readily evident. This patient’s superficial basal cell carcinoma was easily treated with excision. 

David L. Kaplan, MD, is a clinical assistant professor of dermatology at the University of Missouri–Kansas City School of Medicine in Kansas City, Missouri, and at the University of Kansas School of Medicine in Kansas City, Kansas. He practices adult and pediatric dermatology in Overland Park, Kansas.