Epidermoid Cyst versus Basal Cell Carcinoma by Dermoscopy

Abstract

A 70 years old woman presented with a two years history of small white nodules on her eyelids. The small and pigmented lesion had slowly grown since three months ago. She had a previous history of basal cell carcinoma on the chest 7 years ago. On examination there were dome-shaped, flesh colored nodules around the eyelids, the smaller lesion with a central brown-black pigmentation (Figure.1), the big nodule had also a small central black spot and an isolated one. Dermoscopy revealed the central brown circular comedo (Figure 2) situated on a whitish-yellow circular background with some telangiectasias on it due to pressure and skin distension. By dermoscopy the central small brown comedo on the big nodule was revealed (Figure 3) and also the isolated comedo (Figure 4). A presumptive diagnosis of Epidermoid Cysts and facial come dos was made. The patient was insured about the benign nature of the condition and was explained that they should be removed if the appearance bothers or become painful, ruptured or infected.