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Kunz M, Svensson H, Paoli J. Dermoscopic rainbow pattern: A clue to diagnosing aneurysmal atypical fibroxanthoma. JAAD Case Rep 2018; 4:292-294. [PMID: 29693051 PMCID: PMC5911777 DOI: 10.1016/j.jdcr.2017.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Michael Kunz
- Department of Dermatology and Venereology, University Hospital Zurich, Zurich, Switzerland
- Correspondence to: Michael Kunz, MD, Department of Dermatology and Venereology, University Hospital Zurich, Gloriastrasse 31, Zurich 8091, Switzerland.
| | - Helena Svensson
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Moscarella E, Piana S, Specchio F, Kyrgidis A, Nazzaro G, Eliceche ML, Savoia F, Bugatti L, Filosa G, Zalaudek I, Scarfi F, Inskip M, Rosendahl C, Pyne JH, Siggs G, Toğral AK, Cabo H, Drlik L, Lallas A, Longo C, Argenziano G. Dermoscopy features of atypical fibroxanthoma: A multicenter study of the International Dermoscopy Society. Australas J Dermatol 2018; 59:309-314. [PMID: 29569417 DOI: 10.1111/ajd.12802] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/15/2018] [Indexed: 01/23/2023]
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.
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Affiliation(s)
- Elvira Moscarella
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.,Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Simonetta Piana
- Pathology Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Francesca Specchio
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.,Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Athanassios Kyrgidis
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Gianluca Nazzaro
- Department of Physiopathology and Transplantation, University of Milan, UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maite L Eliceche
- Dermatology Unit, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | | | | | | | - Iris Zalaudek
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | | | - Mike Inskip
- Skin Patrol Skin Cancer Clinic, Melbourne, Victoria, Australia
| | - Cliff Rosendahl
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia.,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - John H Pyne
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Graeme Siggs
- SunDoctors Skin Cancer Clinic, Adelaide, South Australia, Australia
| | - Arzu K Toğral
- Faculty of Medicine, Department of Dermatology, Başkent University, Ankara, Turkey
| | - Horatio Cabo
- Dermatology Unit, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Lubomir Drlik
- Department of Dermatology, Šumperk Hospital, Šumperk, Czech Republic
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Caterina Longo
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.,Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
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Pagliarello C, Peccerillo F, Zucchi A, Tortorella RG, Ricci R, Stanganelli I, Feliciani C, Di Nuzzo S. Lesion presenting with a “blue amber” pattern. World J Clin Cases 2016; 4:333-335. [PMID: 27803916 PMCID: PMC5067497 DOI: 10.12998/wjcc.v4.i10.333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 07/31/2016] [Accepted: 08/18/2016] [Indexed: 02/05/2023] Open
Abstract
Atypical fibroxanthoma (AFX) is a spindle cell neoplasm with low metastatic potential but high tendency to recur after surgery. Because of the rarity of this lesion and its aspecific clinical features, AFX could be easily misdiagnosed and undertreated by many clinicians who encounter them. Dermoscopy represents a valuable tool for easily assessing skin lesions, even though histological examination is required for final diagnosis. We report a case of a cheek lesion with dermoscopic “blue amber pattern”, easily recognisable and not observed in others skin tumours, which could represent an additional feature useful in differentiating this tumour from other skin neoplasms.
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Inskip M, Magee J, Weedon D, Rosendahl C. Atypical fibroxanthoma of the cheek-case report with dermatoscopy and dermatopathology. Dermatol Pract Concept 2014; 4:77-80. [PMID: 24855581 PMCID: PMC4029261 DOI: 10.5826/dpc.0402a16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/25/2013] [Indexed: 12/31/2022] Open
Abstract
We present a case report of an atypical fibroxanthoma on the cheek of a 73-year-old man. Clinical, dermatoscopic and dermatopathologic images are presented.
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Affiliation(s)
- Mike Inskip
- Sun Patrol Skin Cancer Clinic, Berwick, Australia
| | - Jill Magee
- Dorevitch Pathology, Heidelberg, Australia
| | - David Weedon
- Sullivan Nicolaides Pathology, Brisbane, Australia
| | - Cliff Rosendahl
- School of Medicine, The University of Queensland, Brisbane, Australia
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Huang HJ, Yu YH, Zheng ZY. Clinicopathologic analysis of primary atypical fibrous xanthoma of the esophagus. Shijie Huaren Xiaohua Zazhi 2010; 18:3020-3025. [DOI: 10.11569/wcjd.v18.i28.3020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To explore the clinical and pathological features of primary atypical fibrous xanthoma of the esophagus, and to analyze its diagnosis, treatment and prognosis.
METHODS: One case of primary atypical fibrous xanthoma of the esophagus treated at Fuzhou General Hospital of Nanjing Military Command of Chinese PLA was analyzed in this study. The diagnosis, treatment and follow-up data as well as histopathological and immunohistochemistry data for the disease were analyzed to reveal the clinicopathologic characteristics of the disease.
RESULTS: The tumor was located under the squamous epithelium of the upper esophagus, with a clear boundary. Histopathological analysis showed that the tumor was composed of cells of spindle, polygonal and irregular shape, collagen fibers, and esophageal glands. The tumor cells consisted of mononuclear, binuclear and polynuclear giant cells that shared some similar morphological characteristics. Mononuclear, binuclear and polynuclear giant cells could be detected in the transitional area. Some areas revealed pathological mitosis (< 2/50 HPF). Immunohistochemistry analysis showed that the tumor cells were strongly positive for CD68, CD163, S-100, and vimentin, weakly positive for α-SMA, h-caldesmon, and Ki-67 (proliferation index: ~8%), but negative of CKpan, EMA, CK (L), CK (H), F8, CD34, CD117, Dog-1, actin, desmin, CD10, and CD99.
CONCLUSION: Primary atypical fibrous xanthoma of the esophagus is an extremely rare mesenchymal tumor with benign behavior and good prognosis. A differential diagnosis should be made among atypical fibrous xanthoma of the esophagus, esophageal sarcomatoid carcinoma, carcinoma-sarcoma, leiomyoma, gastrointestinal stromal tumor, and malignant fibrous histiocytoma.
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