TY - JOUR
T1 - A pearly nodule on an indurated plaque
AU - Miller, Austinn
AU - Siller, Alfredo
AU - Rodriguez, Ramiro
AU - Gill, Pavandeep
AU - Curry, Jonathan L.
AU - Tyring, Stephen K.
N1 - Publisher Copyright:
Copyright 2021 by the author(s).
PY - 2021
Y1 - 2021
N2 - We present an 81-year-old man who presented for evaluation of an indurated plaque with an exophytic, pearly, skin-red-brown colored nodule with central ulceration on his chest that evolved over the course of several months and was initially suspected to be basal cell carcinoma. Biopsy demonstrated histological features of dermal spindle cell proliferation in a storiform fashion with CD34 positivity confirming a diagnosis of dermatofibrosarcoma protuberans (DFSP). Dermatofibrosarcoma protuberans are rare, slowly progressive soft tissue sarcomas. The rate of DFSP is greatest among African Americans (8.3/1,000,000), occurring nearly twice as frequently when compared to Caucasians. Aside from race/ethnicity, age, and skin trauma, no specific risk factors are associated with DFSP. Complete excision is curative. Given its pearly skin colored appearance, papular/ nodular/atrophic morphology variants, and tendency to form indurated plaques, DFSP may be mistaken for nodular and morpheaform basal cell carcinoma subtypes, as well as a variety of other conditions. This case highlights the importance of maintaining DFSP on the differential diagnosis of slowly progressive nodules and indurated plaques, especially in African Americans.
AB - We present an 81-year-old man who presented for evaluation of an indurated plaque with an exophytic, pearly, skin-red-brown colored nodule with central ulceration on his chest that evolved over the course of several months and was initially suspected to be basal cell carcinoma. Biopsy demonstrated histological features of dermal spindle cell proliferation in a storiform fashion with CD34 positivity confirming a diagnosis of dermatofibrosarcoma protuberans (DFSP). Dermatofibrosarcoma protuberans are rare, slowly progressive soft tissue sarcomas. The rate of DFSP is greatest among African Americans (8.3/1,000,000), occurring nearly twice as frequently when compared to Caucasians. Aside from race/ethnicity, age, and skin trauma, no specific risk factors are associated with DFSP. Complete excision is curative. Given its pearly skin colored appearance, papular/ nodular/atrophic morphology variants, and tendency to form indurated plaques, DFSP may be mistaken for nodular and morpheaform basal cell carcinoma subtypes, as well as a variety of other conditions. This case highlights the importance of maintaining DFSP on the differential diagnosis of slowly progressive nodules and indurated plaques, especially in African Americans.
KW - African-American
KW - Basal cell carcinoma
KW - Dermatofibrosarcoma protuberans
KW - Pearly nodule
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U2 - 10.5070/D3271256715
DO - 10.5070/D3271256715
M3 - Article
C2 - 35499445
AN - SCOPUS:85127584868
SN - 1087-2108
VL - 27
JO - Dermatology online journal
JF - Dermatology online journal
IS - 12
M1 - 17
ER -