<p><strong>Clinically</strong> the differential included a basal cell carcinoma or a melanoma. <strong>Dermoscopically</strong> there is asymmetry with branching well-focused vessels (black arrow) and many blue clods (purple arrows) in keeping with a basal cell carcinoma - please refer to the <strong>algorithm</strong>. The lesion was excised with a 4 mm margin of surrounding skin.<br></p>
<p>Some BCC are heavily pigmented. If you have any doubt the patient should be referred as a 2-week wait. <br></p>