Basal cell carcinoma in a giant verrucous epidermal naevus: An uncommon clinicopathological entity

Epidermal nevi (EN), particularly verrucous EN (VEN), are benign hamartomas characterized by hyperplasia of the epidermis and adnexal structures, with rare malignant transformations. This case report highlights a 70-year-old male presenting with a congenital warty growth in the preauricular region since childhood, with a recent history of exacerbation after homeopathic treatment. Clinical and histopathological examinations confirmed the presence of basal cell carcinoma (BCC) arising from VEN, which was histopathologically confirmed by hyperkeratosis, acanthosis, basaloid cell proliferation, and peripheral nuclear palisading. The transformation of VEN to BCC is exceedingly rare, and this case report highlights the potential of the transformation of latent embryonic or pluripotent cells in VEN to undergo neoplastic changes. This report underscores the importance of vigilant evaluation of persistent epidermal lesions and their malignant potential, especially in clinically significant cases.