The classic presentation is a pearly pink or flesh-colored lesion on the face. There may be central erosion or ulcer. Irregular telangiectasias appear on the surface. There are several distinct presentations. Nodular lesions have a smooth elevated surface with prominent telangiectasias.
Pigmented basal cell carcinomas are usually nodular lesions with varying amounts of pigment.
Morpheaform or sclerotic basal cell carcinoma is a flat, waxy, yellow, hard growth with ill-defined borders. These are especially difficult to define and treat and are best treated by Mohs micrographic surgery.
Superficial basal cell carcinoma resembles eczema or psoriasis. It appears to be slightly elevated and scaling. The tumor remains thin for months or years and then slowly penetrates into the skin.