Basal cell carcinoma is the most prevalent form of skin cancer, typically developing on sun-exposed areas like the face and neck. However, BCC affecting the fingers—known as digital BCC—is relatively uncommon, primarily due to the scarcity of sebaceous glands in these regions, which are linked to BCC pathogenesis.

A new case report published in Skin, details a 63-year-old man who sought care for a painful, progressively enlarging lesion on his right middle finger that had been present for three years. Clinical examination showed a 12-mm red plaque topped with two 4-mm bluish-black, firm nodules and surface crusting.

The lesion was surgically excised, and histopathological analysis confirmed a diagnosis of nodular basal cell carcinoma. Microscopic findings revealed tumor nodules composed of basaloid cells with characteristic peripheral palisading and melanin granules within the tumor nests.

The authors note that digital BCC is often misdiagnosed because its appearance mimics other conditions, including melanocytic tumors, squamous cell carcinoma, Bowen disease, and Merkel cell carcinoma. While noninvasive imaging tools such as dermoscopy and reflective confocal microscopy can assist in differential diagnosis, biopsy remains the definitive gold standard.

This case highlights the importance of maintaining clinical suspicion for BCC even in atypical locations. Early recognition and complete surgical excision are essential to prevent local progression and potential complications.
The work titled “Digital Basal Cell Carcinoma” was published in Skin (published on June 8, 2026).
DOI:https://doi.org/10.2738/SKIN.2026.0018