Photoclinic Diagnosis: Basal Cell Carcinoma Arising from Traditional Tattoo

A 72-year-old woman presented with an ulcer on her upper lip since one year ago. On physical examination, there was a pedunculated umbrella-shaped lesion which grew up to obstruct the nostril and down to reach the lower lip. The mass was brown to red with some crust and measured 2×2 cm. The lesion was just on a blue black tattoo. The patient had tattoo from many years ago. The patient did not have any history of skin cancer, radiotherapy, or other risk factors. Routine laboratory tests were within normal limits.