follow @PCDSUKCreated: 9th August 2013 | Last Updated: 23rd November 2014
Introduction
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An atypical fibroxanthoma is a rare, malignant fibrohistiocytic neoplasm, which develops most commonly on the sun-exposed skin of elderly individuals. It has invasive potential, may recur locally after excision, and very rarely metastasizes. This chapter is set out as follows: |
History
- In one study the mean age at presentation was 76 with a male:female ratio of 4:1
Clinical findings
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Distribution
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Most lesions are located on the scalp, cheeks and ears
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Most lesions are located on the scalp, cheeks and ears
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Morphology
- Red, juicy, dome-shaped nodules that may be ulcerated or crusted
- Lesions often grow rapidly, and rarely exceed 3 cm in diameter
- The surrounding skin often shows signs of actinic damage
Images
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Figure: 1 Atypical fibroxanthoma - a very early presentation |
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Figure: 2 Atypical fibroxanthoma |
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Figure: 3 Atypical fibroxanthoma Surrounding skin shows signs of UV damage |
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Figure: 4 Atypical fibroxanthoma Copied with kind permission from Dermatoweb |
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Figure: 5 Close-up of the above |
Management
- Atypical fibroxanthomas can have similar appearances to SCC or other skin malignancies and so patients with such lesions should be referred urgently to Secondary Care as a 2 Week Rule
- Tumours should be excised to include a margin of normal skin