Atypical fibroxanthoma
Atypical Fibroxanthoma (AFX)
Definition & Clinical Presentation
- AFX = superficial, dermally localized fibrohistiocytic neoplasm of UV-exposed skin in older patients.
- Clinical Presentation: ulcerated nodule on UV-exposed skin — bald scalp of older men, ear helix, nose, cheek.
- Patients: male predominance, average age > 70 years, fair skin type.
Histology & IHC
- Dermally localized (NO subcutaneous involvement — key for PDS differentiation!), pleomorphic spindle/giant cells with atypical mitoses.
- IHC: CD10+ + CK− + S100− + p63− — exclusion of SCC + melanoma is mandatory.
- Key DD: must exclude spindle cell SCC + amelanotic melanoma, as they are clinically similar.
Differential diagnoses
- Dermatofibroma
- Basal cell carcinoma
- Keratoacanthoma
- Melanoma
- Cutaneous angiosarcoma
- Kaposi's sarcoma
- Cutaneous squamous cell carcinoma
Practise Atypical fibroxanthoma in the app
Flashcards with spaced repetition, exam questions and spot-the-diagnosis on this topic – in DermaFuchs, free of charge.
In the DermaFuchs app: 2 flashcards · 2 clinical images
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Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.