Background: Basal cell carcinoma (BCC) is the most common skin malignancy. It often occurs on sun-exposed areas as a result of ultraviolet radiation. Genital region is a rare location for the presentation of BCC, accounting for approximately 2% of all BCC cases.

Observation: A sixty-one-year-old woman referred to our out-patient clinic with unilateral vulvar pruritus for ten years. She had used topical corticosteroids and antifungal creams without any relief. A well-demarcated erythematous, slightly elevated and pigmented plaque was seen on the right labia majora skin on dermatologic examination. Histopathologic examination of the lesion was compatible with superficial BCC. Imiquimod 5% cream for five consecutive days per week was prescribed to our patient.

Key message: In the vulvar area, basal cell carcinoma has a potential for delay in diagnosis. Because, this site is less likely to be monitored by both patients and clinicians. Furthermore, clinical signs may mimic other common dermatologic pathologies of vulva.