Wolf's isotopic response of basal cell carcinoma following facial herpes zoster infection: a rare presentation

Basal Cell Carcinoma (BCC) is a slow growing, locally invasive tumour, which arises from pluripotent cells within the basal layer of epidermis or follicular structures, uncommon in dark skinned individuals with occurrence in females vis-à-vis males being lower.^[1] Here we report a rare case of 60 year old Indian female, who presented with hyperpigmented nodules over right infra-orbital region, which was asymptomatic and had previous history of herpes zoster at the same site. Biopsy revealed the lesion to be BCC. Hence, Wolf's isotopic response is the occurrence of a new dermatosis at the site of previous herpes zoster infection. Nodular BCC comprises about 50–80% of all BCC and lesions are more frequently found on face, commonly affecting the forehead, peri-orbital area and cheeks. We further hypothesize immunological cause to lead mutations and subsequent occurrence of carcinoma and plead for further dermatological research in the same area.