Figure 6.

BCC with extensive subclinical extension. (A), Surgical margins of the first stage. (B), First stage margins based on dermoscopy, with fine telangiectasias and white red structureless areas. Although the figure shows many telangiectasias surrounding the first stage margin, these telangiectasias were interpreted as resulting from photodamage since they were widely distributed on his central face. After margins were clear, similar telangiectasias were still present surrounding the defect. (C), Histological section of the specimen obtained with Mohs surgery showing nests of basaloid cells adjacent to or conected to the epidermis, consistent with mixed basal cell carcinoma (Hematoxylin & eosin, ×40). (D), Digital map of the first stage. White lines indicate the presence of residual tumor. (E), Surgical wound after 6 stages, with the involvement of the left nasal wall and medial malar region. (F), 2-months postoperatively. Cheek restored with primary closure and nasal sidewall with Burow full-thickness skin graft and second intention healing.