Lepromatous leprosy, melanoma, and basal cell carcinoma: cli
Basal cell carcinoma (BCC) is one of the most common malignant skin tumors, accounting for about 75% of all skin cancers, most commonly manifested on sun-exposed skin such as the head and neck of older individuals. Melanoma is the most aggressive cutaneous malignancy and represents 10% of all skin cancer diagnosed. Melanoma is less common but more aggressive than BCC.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an intracellular parasite that mainly affects skin and peripheral nerves, with tropism for macrophages and Schwann cells. The disease is transmitted through prolonged contact with untreated lepromatous leprosy patients. The coexistence of BCC and leprosy in the same lesion is uncommon, but it has been previously documented.

This case reports a 49-year-old male with an ulcerated plaque on the right lateral nasal wall, bright papules on the sternal region, and a blackened plaque on the right temporal region. The nasal and temporal lesions were diagnosed by histopathology as basal cell carcinoma and melanoma, respectively. The sternal lesions were excised with the repair of the “dog ear” which histopathological examination showed macrophages in the dermis parasitized with acid-fast bacilli, confirming the diagnosis of lepromatous leprosy with Fite-Faraco staining. This case report highlights the importance of referring the dog-ear specimen for histopathologic analysis.

Source: https://www.sciencedirect.com/science/article/pii/S0365059619300406