Cutaneous epidermal cysts are common benign lesions derived from the epidermis or hair follicle epithelium, and malignant transformation is rare. When it occurs, squamous cell carcinoma is the predominant malignancy, whereas basal cell carcinoma (BCC) is uncommon. We present the case of a 60-year-old woman with basal cell carcinoma originating from an epidermal cyst on the nasal dorsum. Immunohistochemical staining for BCL2 and CD10 was positive. To our knowledge, there have been 12 reported cases of BCC originating from epidermal cysts. We reviewed these reports to identify potential clinicopathologic trends. We suggest that longstanding epidermal cysts may have a risk of malignant transformation, possibly triggered by chronic irritation. We emphasize that cystic lesions showing progressive growth should be excised and examined histopathologically.

Osama Alsharif attained board certifications in dermatology from Saudi Arabia, Jordan, and the Arab Board. He successfully completed clinical fellowships in Pediatric Dermatology at the University of Miami Hospital (USA) and Great Ormond Street Hospital (UK). With over 15 years of experience, he has contributed to the field of dermatology through multiple publications. Dr. Alsharif remains committed to staying abreast of the latest advancements in his field by actively participating in conferences and workshops.