The pink papule in an old surgical scar is characteristic or recurrent BCC. The old surgical scar can be seen extending downward from the tumor. This lesion had been excised twice previously. Since basal cell carcinoma is as common (1 million/year in USA) as all other cancers combined, there are a lot of recurrences, even though the initial cure rate averages 90%. Recurrent BCCs spread in an unpredictable fashion, which results in the lower cure rate for these lesions.