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BPO). Each received the standard Mohs beveled incision a few millimeters beyond the visual tumor margin that continued along a horizontal plane and resulted in a thin disc of excised tissue.Seventy-one percent of non-CWNMSCs were cleared in 1 stage, and 24% were cleared in 2 stages. In contradistinction, 33% of CWBCCs were cleared in 1 stage. Moreover, 33% of CWBCCs required $3 stages compared to 5% of non-CWNMSCs. These differences were statistically significant.Postoperative defects also revealed statistically significant differences. Sixty-three percent of non-CWNMSCs left wounds \2 cm in diameter compared to 14% of CWBCCs. Forty-eight percent of CWBCCs had defects [3 cm compared to 11% of non-CWNMSCs. The central facial location (90%) in CWBCCs adds to the impact.In the literature, the aggressive BCC-a composite term including, like CWBCCs, infiltrative, morpheaform, and micronodular histologic subtypes-has an incidence of 20% to 30% of all BCCs. 4,5 In this study, CWBCCs accounted for 2% of NMSCs, 2.8% of BCCs, and 9% to 14% of aggressive BCCs.This study describes the candle wax sign, a visual clue associated with a subtle niche of aggressive BCCs. Awareness of this clinical finding can avert the diagnostic delay, extensive surgery, and significant aesthetic damage associated with CWBCC treatment.

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