Adnexal iceberg: pruritic papule on top of a nodule on the back.

Basal cell carcinoma (BCC), one of the most common malignancies, is rarely associated with follicular and apocrine differentiation patterns. This case presents a case of BCC with atypical gross presentation and features of aberrant differentiation. Clinicians should maintain a high level of clinical suspicion for BCC in atypical lesions. Click here for the corresponding questions to this CME article.