C A S E R E P O R T Pigmented basal cell carcinoma of the eyelid in Hispanics Lily Koo Lin1 Han Lee2 Eli Chang1 1Department of Oculoplastics, Doheny Eye Institute, Los Angeles, CA, USA; 2Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA Correspondence: Eli Chang Doheny Eye Institute, 1450 San Pablo Street DEI 4705, Los Angeles, CA 90033, USA Tel +1 323-442-6405 Email oculoplastics@doheny.org Background: Pigmented basal cell carcinoma (PBCC) of the eyelid has not been well cited in the literature, and is often overlooked in the differential diagnosis of pigmented eyelid lesions. We aim to describe PBCC of the eyelid in Hispanic patients. Methods: Retrospective review of patients with eyelid skin cancer who presented to the Depart- ment of Dermatology at the Keck School of Medicine of the University of Southern California and the Doheny Eye Institute from January 2002 to November 2005. Results: Sixty-nine of the 79 patients with eyelid skin cancer had basal cell carcinoma. Eight of these patients were Hispanic. Four of the eight Hispanic patients had PBCC. Conclusions: Although eyelid PBCC is regarded as a rare condition, it may occur more com- monly in the Hispanic population and should be remembered in the differential diagnosis of pigmented eyelid lesions. Keywords: pigmented basal cell carcinoma, eyelid, skin cancer, lesions Although pigmented basal cell carcinoma (PBCC) in individuals with darker skin color has been well described in dermatologic literature, it is recognized as a rare condition in the general population, and has rarely been reported speciﬁcally to the eyelid region (Duke-Elder and MacFaul 1974; Charles 1975). Since PBCC is not com- monly considered in the differential diagnosis by general ophthalmologists for eyelid lesions, it is often mistaken for melanoma (Scotto et al 1983). Indeed, some features of PBCC lesions, such as its irregular borders and dark pigment, are suggestive of melanoma (Pathak et al 1982). Reports of frequency vary. The frequency for all sites ranges from 1.1% to 8% (Bart and Schnall 1973). In one series that investigated the eyelid site only, 9% of all diagnosed basal cell carcinomas in a population of white patients were found to be PBCC (Hornblass and Stefano 1981). Although Hispanic patients get skin cancer signiﬁcantly less frequently than non- Hispanic individuals (Pathak et al 1982; Harris et al 2001), PBCC of all sites has been shown to occur more frequently in Hispanics than in non-Hispanics (Bigler et al 1996). We have seen PBCC of the eyelid occurring with common frequency in our Hispanic patients. Our case series describes four of eight Hispanic patients who presented with primary eyelid malignant lesions that were proven on biopsy to be PBCC. Materials and methods Clinical medical records for patients seen between January 2002 and November 2005 by the Mohs surgery division of the Department of Dermatology at the Keck School of Medicine of the University of Southern California were reviewed retrospectively. Seventy-nine consecutive cases of primary eyelid skin cancer were found. Cases of eyelid basal cell carcinoma in patients of Hispanic descent were identiﬁed and studied. Hispanic descent was determined by heritage documentation based on questions asked Clinical Ophthalmology 2008:2(3) 641–643 © 2008 Lin et al, publisher and licensee Dove Medical Press Ltd.This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. 641