Most commonly seen in the lower lid and medial canthal region
Clinical Features
Present as nodular, diffuse (morpheaform), ulcerated, or multicentric lesions
Initially the lesion is a discrete nodule with or without ulceration, which eventually becomes ulcerated centrally with waxy rolled border
Tumor infiltration to the adjacent structures can extend to the globe, bone and surrounding tissues and may cause frozen globe. This is most commonly seen with basal cell affecting the medial canthus
Metastases are rare but recurrences are not uncommon
Management
Excisional surgery and Mohs' surgical technique, which has become increasingly more popular because it is very effective in excising the entire tumor mass with microscopically proven tumor free margins
Reconstructive surgery is usually required after Moh's surgery