Uncommon Manifestation of Basal Cell Carcinoma on the Fingers: A Case Report and Review of the Existing Literature

TL;DR

A rare case of basal cell carcinoma on a finger is reported, highlighting unusual risk factors like HIV and hot oil exposure.

Contribution

The paper presents a novel case linking occupational and iatrogenic factors to finger BCC in an HIV-positive patient.

Findings

Nodular-type BCC occurred on a finger without trauma or family history of skin cancer.

Occupational and iatrogenic factors like hot oil spillage and HIV may contribute to finger BCC.

Wide excision and flap reconstruction were used successfully in this atypical case.

Abstract

Basal cell carcinoma (BCC) is a commonly occurring cutaneous malignancy predominantly affecting sun‐exposed areas. While the face and neck are typical sites, distal extremity involvement is rare. This case report presents an atypical case of nodular‐type BCC arising on the right ring finger of a 49‐year‐old male with a history of HIV infection and anabolic steroid use. The absence of any significant trauma and familial predisposition to skin cancer in this patient underscores the importance of considering alternative risk factors. A comprehensive literature review revealed that while sun exposure, scarring, and immunosuppression are established risk factors for finger BCC, our case highlights the potential role of occupational and iatrogenic factors, such as hot oil spillage and HIV, in the pathogenesis of this uncommon malignancy. Notably, the thumb is the most frequent site of finger BCC, with the nodular subtype being the predominant histological variant. Surgical excision, often employing Mohs micrographic surgery, remains the gold standard treatment. In this case, wide excision and dorsal metacarpal artery flap reconstruction were performed. This report expands our understanding of the diverse clinical presentation of BCC and emphasizes the need for a thorough evaluation of potential risk factors in atypical cases.

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