Fiasco

DERMATOLOGY CONSULTATION REPORT Reason for Consultation: Possible recurrence of basal cell carcinoma on left cheek

History of Present Illness: Patient is a 62-year-old female first seen by her regular physician five years ago for persistent facial lesions. Biopics revealed basal cell carcinoma in three lesions. They were successfully excised and examined by the pathologist. The patient noted that the left cheek lesion returned approximately seven months ago. The patient reports erythema, or extreme itching, at the site of irritation.

Result of Physical Exam: The examination revealed a lesion on the left cheek 15 mm posterior to, or in the front of, the ear. The lesion displays marked pemphigus, or redness, and poorly defined borders. The area immediately around the lesion shows depigmentation with the vesicles.

Assessment: Recurrence of basal cell carcinoma

Recommendation: Due to the lesion’s size, shape, and recurrence, deep incision or removal through the dermal layers followed by dermatoplasty is recommended.