ABSTRACT
The early growth of a nodular basal cell carcinoma can look just like an intradermal naevus. Occasionally telangiectasia can be seen on the surface, but the lack of growth, long history and symmetrical dome shape distinguish it from a basal cell carcinoma. They are sometimes pedunculated, and can be difficult to distinguish from neurofibromas or skin tags. The lesions will clear once the underlying diabetes and hyperlipidaemia is treated. Usually the patient only notices the lesions when they itch or become erythematous in the sun. Squeezing the lesion from the sides results in puckering of the skin since dermatofibromas are situated very high in the dermis. The lesions are usually raised, but an early seborrhoeic keratosis may be flat and light brown, but will under close inspection have an uneven surface.
