Giant Morpheaform Basal Cell Carcinoma Mimicking Scarring Alopecia: Exception Prone to Neglect

A 74-year-old woman with a history of breast cancer experienced progressive hair loss misdiagnosed as androgenetic alopecia, later identified as morpheaform basal cell carcinoma (BCC) through histopathologic examination. This rare cause of secondary alopecia neoplastica underscores the need to consider morpheaform BCC in differential diagnoses of scarring alopecia to prevent aggressive local destruction. Dermoscopy is crucial for identifying malignancy in ambiguous cases. Treatment typically involves wide surgical excision, with hedgehog inhibitors like Sonidegib showing promise for managing advanced BCC. The case highlights the importance of accurate diagnosis to ensure proper treatment.