Background.: Basal cell carcinoma (BCC) is the most common malignancy in whites, but it rarely occurs in dark persons. Objective.: To report a BCC on the hairy scalp of an Asian Indian female with no obvious risk factors except previous scalp trauma. Methods.: We review the English literature concerning BCC in Indians, and compare this with data for North American blacks and whites; and reports of BCC arising in areas of prior trauma. Results/Conclusion.: Skin cancer accounts for 1-2% of malignancies in blacks and Indians, compared with one-third of neoplasms in whites. BCC comprises 75% of skin cancers in whites, but squamous cell carcinoma represents 60-65% of skin cancers in blacks and Indians. Although most BCCs occur in sun-exposed areas in whites, blacks, and Indians, a significant percentage also develop in photoprotected areas. Trauma may be a significant risk factor for BCC, either with actinic damage or alone, as in our case.
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