Sequential Periocular Basal Cell Carcinomas and the Impact of Delayed Follow-up During the COVID-19 Pandemic

Periocular basal cell carcinoma (BCC) may present with subtle or deceptive clinical features, and interruptions in follow-up can allow the development of additional lesions.This report presents a case of a 60-year man who initially presented for cataract assessment, during which a suspicious right upper eyelid lesion was detected and surgically excised with histological confirmation of nodular BCC.Subsequent follow-up was interrupted during the COVID-19 panademic.Five years later, he re-presented with a new pigmented nodule at the left palpebromalar region, which demonstrated progressive morphological change and was again confirmed as nodular BCC following excision.Cataract surgery subsequently restored visual acuity to 6/6 in both eyes, and the patient has remained free of recurrence for three years.This case illustrates the importance of continuous surveillance and timely intervention in periocular skin malignancies, particularly when routine care is disrupted.