Uncommon Manifestation of Basal Cell Carcinoma on the Fingers: A Case Report and Review of the Existing Literature.

Basal cell carcinoma (BCC) is a commonly occurring cutaneous malignancy predominantly affecting sun-exposed areas. While the face and neck are typical sites, distal extremity involvement is rare. This case report presents an atypical case of nodular-type BCC arising on the right ring finger of a 49-year-old male with a history of HIV infection and anabolic steroid use. The absence of any significant trauma and familial predisposition to skin cancer in this patient underscores the importance of considering alternative risk factors. A comprehensive literature review revealed that while sun exposure, scarring, and immunosuppression are established risk factors for finger BCC, our case highlights the potential role of occupational and iatrogenic factors, such as hot oil spillage and HIV, in the pathogenesis of this uncommon malignancy. Notably, the thumb is the most frequent site of finger BCC, with the nodular subtype being the predominant histological variant. Surgical excision, often employing Mohs micrographic surgery, remains the gold standard treatment. In this case, wide excision and dorsal metacarpal artery flap reconstruction were performed. This report expands our understanding of the diverse clinical presentation of BCC and emphasizes the need for a thorough evaluation of potential risk factors in atypical cases.