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Australas J Dermatol. 2018 Nov;59(4):309-314. doi: 10.1111/ajd.12802. Epub 2018 Mar 23.

Dermoscopy features of atypical fibroxanthoma: A multicenter study of the International Dermoscopy Society.

Author information

1
Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.
2
Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy.
3
Pathology Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.
4
Department of Physiopathology and Transplantation, University of Milan, UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
5
Dermatology Unit, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
6
Unit of Dermatology, AUSL Ravenna, Ravenna, Italy.
7
Dermatology Unit, 'Carlo Urbani' Hospital, Jesi, Italy.
8
Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy.
9
Dermatology Unit, University of Florence, Florence, Italy.
10
Skin Patrol Skin Cancer Clinic, Melbourne, Victoria, Australia.
11
School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
12
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
13
SunDoctors Skin Cancer Clinic, Adelaide, South Australia, Australia.
14
Faculty of Medicine, Department of Dermatology, Başkent University, Ankara, Turkey.
15
Dermatology Unit, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
16
Department of Dermatology, Šumperk Hospital, Šumperk, Czech Republic.
17
First Department of Dermatology, Aristotle University, Thessaloniki, Greece.
18
Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy.

Abstract

BACKGROUND/OBJECTIVES:

Little is known about the dermoscopic features of atypical fibroxanthoma.

METHODS:

This was a case-control study. Atypical fibroxanthoma lesions were compared with a control group with non-melanoma skin cancer.

RESULTS:

Altogether 40 atypical fibroxanthoma were collected. Most developed in men (93%), appearing mainly as nodular (63%), amelanotic (93%) and ulcerated (78%) lesions. Most lesions were located on the scalp (55%) and the ears (13%). Dermoscopically, most atypical fibroxanthoma displayed red (83%) and white (70%) structureless areas and irregular linear vessels (43%). A series of features achieved statistical significance when comparing atypical fibroxanthoma with non-melanoma skin cancer. The presence of red and white structureless areas and white lines, and the absence of yellowish-white opaque scales, hairpin vessels and arborising vessels were predictive of atypical fibroxanthoma in univariate analysis. However, when squamous cell carcinoma was excluded from the analysis, none of the criteria achieved statistical significance. When basal cell carcinoma was excluded, three variables achieved statistical significance in predicting atypical fibroxanthoma: red, structureless areas, the absence of opaque yellowish-white scales and absence of white circles.

CONCLUSIONS:

Atypical fibroxanthomas seem to be barely distinguishable from basal cell carcinoma dermoscopically, but they are more easily distinguishable from a well to moderately differentiated squamous cell carcinoma. A histopathological examination is needed for the final diagnosis.

KEYWORDS:

atypical fibroxanthoma; dermoscopy; non-melanoma skin cancer

PMID:
29569417
DOI:
10.1111/ajd.12802
[Indexed for MEDLINE]

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