Linear basal cell carcinoma (BCC) is a rare, underdiagnosed lesion that is considered to be a distinct clinical entity. We report an interesting case of a linear BCC, to highlight the importance of identifying these tumours and managing them appropriately.

Retrospective case report.

A 48 year old lady presented to the eye department with a chronic scar in the left periocular region. There was a history of trauma to the same area many years previously, and she described recurrent bleeding from the scar. Examination revealed a linear BCC along the left nasojugal skin crease. She underwent a 3mm margin controlled excision with frozen section. The excision site was reconstructed using a nasojugal rotational flap along the skin crease. Histological analysis confirmed a nodular BCC subtype.

Linear BCC was originally described in 1985, but is frequently underdiagnosed due to it masquerading as a scar. Our case is a classical presentation of a linear BCC, typically located along relaxed skin tension lines. Due to subclinical extension and aggressive tumour behaviour, MOHS or frozen section excision is important. A low index of suspicion is paramount for the clinician when examining a patient with a long history of a scar.