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Figure 1.
A 65-year-old man with a history of various facial skin cancers presents with multiple, bilateral, pigmented eyelid lesions, including an ulcerated lesion of the left lower eyelid with pigmentation at the margin of the lesion. Biopsies from the right medial canthus (bolded arrow), left upper and lower eyelids (arrows) were all diagnosed as pigmented nodular basal cell carcinomas.
Figure 2.

A. Microscopic examination demonstrates a heavily pigmented nodular basal cell carcinoma from the right upper eyelid. B. Bleached sections reveal atypical basophilic tumor cells. C. Using a red reaction product to distinguish from inherent pigmentation in the lesion, tumor cells demonstrate positivity for S-100. (A. H&E × 200, B. Bleach × 200, C. ICH for S-100 (red) × 200).
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