Recurrent intraepidermal carcinoma of the scalp: A common skin malignancy presenting important management considerations on a high-risk site

A man aged 60 years presented with an irregularly shaped erythematous scalp plaque with a 5 cm diameter (Figure 1). Dermoscopy revealed white scar-like features and coiled vessels (Figure 2). The remaining scalp was heavily sun damaged with numerous actinic keratoses. The lesion had been treated previously with liquid nitrogen cryotherapy and photodynamic therapy (PDT). A shave biopsy measuring 16 mm × 7 mm × 1 mm confirmed an intraepidermal carcinoma (IEC); the base was not transected and there was no invasion.