Morpheaform Basal Cell Carcinoma in a Young Black Woman

Abstract

Basal cell carcinomas are uncommon in black patients, and morpheaform basal cell carcinomas are an uncommon histologic subtype. This case report describes the rare occurrence of a morpheaform basal cell carcinoma in a relatively young black patient. This patient underwent Mohs micrographic surgery as the primary therapy for this tumor. Some features of morpheaform basal cell carcinomas are reviewed, and basal cell skin cancer in blacks is discussed.

Skin cancer in skin of color

“…2,42,60,71 In whites, blacks, and Asians, nodular BCC is the most common histopathologic type of BCC. 41,43,72,78,120 There may be a relatively higher incidence of the adenoid type in blacks and Asians. 121,122 The morpheaform variety of BCC is rare in blacks and appears less frequently than in Caucasians.…”

“…12 The clinical presentation and histologic features of BCC are similar in blacks, Asians, and Caucasians. 42,43,72,98,99 However, Kidd et al demonstrated immunoperoxidase staining for carcinoembryonic antigen in a higher percentage of BCCs in blacks compared with whites, indicating a greater tendency of differentiation toward follicular, eccrine, or sebaceous structures. 100 Most ethnic patients with BCC are elderly and present with asymptomatic, translucent, solitary nodules with central ulceration (Figs 9 and 10).…”

“…1,12,72,[96][97][98] One study showed physical and thermal trauma to be particularly important risk factors for BCC in Asian Indians. 12 BCC that arises in scars typically develops in sun-exposed areas on older patients.…”

“…19 Although some studies report a higher incidence of BCC among black females than among black males, 41,71 others have shown a near equal incidence between the 2 sexes. 2,72 The male-to-female ratio of BCC in Asians in 2 large series ranged from 0.94 to 0.97. 43,78 In Hispanics and whites BCC tends to be more common among males, with an even higher male-to-female ratio in studies of white and Hispanic populations in tropical areas.…”

“…2,12 Only about 1.8% of BCCs occur in blacks, and BCC is approximately 19 times more common in whites. 71,72 On the basis of data from 6 large medical centers, the prevalence of BCC in North American blacks averages 1% to 2% per year. 1,4,73 BCC is the most common skin tumor in Japan, accounting for 47% of all cutaneous malignancies in one study, a survey of 101 institutions from 1987 to 1996.…”