Multiple Basal Cell Carcinomas in a Young Adult Treated with Imiquimod

We present a case of basal cell carcinoma that is unique in the literature with regard to the rare combination of age of onset and number of BCCs at initial presentation that was successfully treated with imiquimod 5%. The patient is a 28-year-old Caucasian man with no past medical or dermatological history. Physical exam was remarkable for seven pink translucent skin lesions on the forehead, alar ridge, zygoma, and upper back. There were no signs or symptoms of a syndrome or disease entity known to cause BCC. Shave biopsies revealed basal cell carcinoma in all 7 lesions. The patient was successfully treated with topical imiquimod 5% 6 days per week for 6 weeks. The presentation of this number of de novo BCCs in a patient this young in absence of a known BCC syndrome has, to the best of our knowledge, not previously been reported in the literature and was successfully treated with imiquimod 5%.