Cutaneous Leishmaniasis in the North of Italy

under the supervision of physicians is almost zero. Tbe patient is aware of his giant basal cell carcinoma and either does not seek treatment after the first recurrence or delays treatment. Generally, the patient is aware of the growth of his basal cell carcinoma over time and chooses not to deal with the thorny problem of the threatening tumor. It is therefore my contention that irrespective of whether the tumor was treated once or several times, the important factor is that, although aware of the problem, the patient allowed tbe tumor to achieve large size over a period of many years. Only with continuous growtb over a period of 10 to 20 years may tumors achieve the size of giant basal cell carcinoma. An early failure to cure cannot be regarded as the primary cause of giant basal cell carcinoma, when the patient is aware of the continued growth for decades.