Basal cell carcinoma. Eyelid carcinoma. Eyelid. Hedgehog pathway inhibitor. Sonidegib Dear Editor, Basal cell carcinoma (BCC) is the most common malignant tumor in the periocular region [1, 2]. The vast majority of periocular BCCs can be effectively treated by complete histopathology-controlled excision, the gold standard for BCC treatment [3]. However, in some cases, alternative approaches are required due to advanced stage of the BCC, reduced general condition of the patient prohibiting general anesthesia, unreasonable cosmetic changes after surgery, or multiple BCC lesions such as in Gorlin-Goltz-syndrome [4]. These alternative approaches include among others systemic therapy with immune checkpoint inhibitors such as sonidegib [4, 5]. Sonidegib (Odomzo®), an oral hedgehog pathway inhibitor (HPI), is indicated for the treatment of adults with locally advanced BCC (laBCC) that are not candidates for surgery or radiation therapy or adults with recurrent laBCC following surgery or radiation therapy [6, 7]. Until today, there is no report of sonidegib for treating periocular laBCC, and evidence regarding optimal management of this condition is still limited. Hence, we demonstrate a case of a laBCC on the lower eyelid margin which was successfully treated with sonidegib. A 73-year-old man with a 20-year history of multiple BCCs at his back, chest, nose, and ear presented with a morphea-like BCC of the left lower eyelid along with an