24/02/2026
This gent first noticed this spot about 6 months ago. It was a scab that didn’t heal.
He had had a previous aggressive basal cell cancer lower down his face in 2018. If you rewatch the video, you’ll probably spot the old scar.
This scab is a worrying scab because it is starting to pucker the surrounding skin. Can you see the skin folds radiating out from the edge of the scab? This has been described as a ‘stellate’ pattern, and is a clue to infiltrative basal cell cancer. It has a reported specificity of 94% for infiltrative BCC 🤓.
The fact that more than 50% of the lesion surface is ulcerated (the scab or crust overlies an ulcer and is our clue to ulceration) is also a clue to aggression in a basal cell cancer.
For professional followers, it is important to take your biopsy from the ulcerated area as, if you only biopsy the intact periphery of the lesion, you may only see nodular basal cell cancer and so underestimate the clearance required by your definitive excision.
Want to see me? ➡️ Sherbourne Road Medical Clinic, Montmorency VIC 3094.
Email me at ask@dranneconnell.com.au if you need an urgent appointment.