Practical Dermoscopy
Fibroepithelioma of Pinkus: A Basal Cell Carcinoma With Distinctive Dermoscopic Features
Fibroepitelioma de Pinkus: un carcinoma basocelular con una dermoscopia distintiva
C. Cuenca-Barrales, J.C. Ruiz-Carrascosa, R. Ruiz-Villaverde
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Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Campus de la Salud de Granada, Granada, España
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Cuenca-Barrales, J.C. Ruiz-Carrascosa, R. Ruiz-Villaverde" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Cuenca-Barrales" ] 1 => array:2 [ "nombre" => "J.C." "apellidos" => "Ruiz-Carrascosa" ] 2 => array:4 [ "nombre" => "R." "apellidos" => "Ruiz-Villaverde" "email" => array:1 [ 0 => "ismenios@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Campus de la Salud de Granada, Granada, España" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fibroepitelioma de Pinkus: un carcinoma basocelular con una dermoscopia distintiva" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 834 "Ancho" => 750 "Tamanyo" => 76563 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy. Dermlite DL3<span class="elsevierStyleSup">®</span> ×10: whiteish areas (fx1), fine arboriform vessels (●), whiteish striations, (fx2), and follicular keratotic plugs (→).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case Description</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 68-year-old man with no family or personal past history of interest consulted with a nonulcerated tumorous lesion that had appeared 3 years earlier on the left side of the torso. Clinical examination revealed a nonulcerated, pearl-like sessile tumor with a maximum diameter of 1.2<span class="elsevierStyleHsp" style=""></span>cm and superficial telangiectasia (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Dermoscopy revealed whiteish areas, fine arboriform blood vessels, whiteish striations, and follicular keratotic plugs (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Histology supported the clinical diagnosis of fibroepithelioma of Pinkus (FeP).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Comment</span><p id="par0010" class="elsevierStylePara elsevierViewall">The first reported cases of FeP were published in 1953 by Herman Pinkus and described as premalignant fibroepithelial skin tumors. Whether it is a rare variety of basal cell carcinoma (BCC) or a benign adnexal tumor with follicular differentiation has been the subject of debate for some time.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> The latest hypotheses situate the entity as an intermediate form between trichoblastoma and BCC, with difficult clinical diagnosis and particularly slow growth.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">FeP is more frequent in middle-aged patients, has no predilection for sex, and is mainly located on the torso. It usually presents as a nodule, and occasionally a plaque, that is well-demarcated, solitary, sessile and firm, smooth, slightly raised, flesh-colored or pink, asymptomatic, and slow-growing. Other clinical forms have been reported, such as more pedunculate, polypoid, giant, and ulcerated forms, as well as brown or grayish forms. The differential diagnosis should include skin tags, intradermal melanocytic nevus, neurofibroma, and seborrheic keratosis.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In 2005, Zalaudek et al. provided the first dermoscopic descriptions of FeP, which would later become differentiated dermoscopic patterns.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">All the lesions examined in that study were red to yellowish light brown, associated with long, linear, irregularly distributed telangiectasia. This vascular pattern, consisting of smaller-caliber arborescent telangiectasia with fewer ramifications, differs clearly from the vascular pattern of BCC. Other notable characteristics of that pattern to consider are the presence of whiteish striations that sometimes cover larger areas or form a honeycomb pattern, indicating a highly collagenized or fibrotic stroma (90% of reported cases), brownish-grey unstructured pigmentation, punctate vessels and milia-like cysts, and follicular keratotic plugs.</p><p id="par0030" class="elsevierStylePara elsevierViewall">A new pattern has recently been reported, consisting of whiteish reticular lines (inverted reticular pattern or reticular depigmentation), as can be observed in nevi, particularly Spitz nevus, melanoma, and some forms of dermatofibroma.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> Some authors have even considered it to be a dermoscopic simulator of malignant melanoma.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">We consider dermoscopy to be a useful tool for supporting the clinical diagnosis of this type of lesion.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case Description" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Comment" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of Interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cuenca-Barrales C, Ruiz-Carrascosa JC, Ruiz-Villaverde R. Fibroepitelioma de Pinkus: un carcinoma basocelular con una dermoscopia distintiva. Actas Dermosifiliogr. 2018;109:908–909.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 563 "Ancho" => 750 "Tamanyo" => 58574 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Polypoid, nonulcerated, pearl-like tumor with superficial telangiectasia.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 834 "Ancho" => 750 "Tamanyo" => 76563 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy. Dermlite DL3<span class="elsevierStyleSup">®</span> ×10: whiteish areas (fx1), fine arboriform vessels (●), whiteish striations, (fx2), and follicular keratotic plugs (→).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fibroepithelioma of Pinkus is a true basal cell carcinoma developing in association with a newly identified tumour-specific type of epidermal hyperplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Sellheyer" 1 => "P. Nelson" 2 => "H. 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Segura" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1346-8138.13485" "Revista" => array:6 [ "tituloSerie" => "J Dermatol" "fecha" => "2017" "volumen" => "44" "paginaInicial" => "542" "paginaFinal" => "543" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27334069" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010900000010/v1_201812060634/S1578219018303779/v1_201812060634/en/main.assets" "Apartado" => array:4 [ "identificador" => "19289" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Practical Dermoscopy" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010900000010/v1_201812060634/S1578219018303779/v1_201812060634/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018303779?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 23 | 12 | 35 |
| 2024 October | 166 | 76 | 242 |
| 2024 September | 166 | 58 | 224 |
| 2024 August | 206 | 108 | 314 |
| 2024 July | 243 | 77 | 320 |
| 2024 June | 185 | 64 | 249 |
| 2024 May | 173 | 62 | 235 |
| 2024 April | 157 | 45 | 202 |
| 2024 March | 163 | 43 | 206 |
| 2024 February | 197 | 39 | 236 |
| 2024 January | 169 | 41 | 210 |
| 2023 December | 196 | 20 | 216 |
| 2023 November | 249 | 39 | 288 |
| 2023 October | 251 | 36 | 287 |
| 2023 September | 215 | 47 | 262 |
| 2023 August | 268 | 29 | 297 |
| 2023 July | 188 | 45 | 233 |
| 2023 June | 205 | 26 | 231 |
| 2023 May | 326 | 29 | 355 |
| 2023 April | 198 | 32 | 230 |
| 2023 March | 199 | 31 | 230 |
| 2023 February | 175 | 42 | 217 |
| 2023 January | 176 | 32 | 208 |
| 2022 December | 162 | 40 | 202 |
| 2022 November | 121 | 24 | 145 |
| 2022 October | 121 | 25 | 146 |
| 2022 September | 141 | 43 | 184 |
| 2022 August | 118 | 27 | 145 |
| 2022 July | 80 | 36 | 116 |
| 2022 June | 69 | 32 | 101 |
| 2022 May | 159 | 46 | 205 |
| 2022 April | 220 | 38 | 258 |
| 2022 March | 184 | 49 | 233 |
| 2022 February | 161 | 30 | 191 |
| 2022 January | 203 | 47 | 250 |
| 2021 December | 194 | 53 | 247 |
| 2021 November | 219 | 65 | 284 |
| 2021 October | 233 | 77 | 310 |
| 2021 September | 213 | 50 | 263 |
| 2021 August | 198 | 50 | 248 |
| 2021 July | 212 | 28 | 240 |
| 2021 June | 156 | 39 | 195 |
| 2021 May | 206 | 56 | 262 |
| 2021 April | 475 | 63 | 538 |
| 2021 March | 214 | 45 | 259 |
| 2021 February | 158 | 48 | 206 |
| 2021 January | 156 | 30 | 186 |
| 2020 December | 136 | 29 | 165 |
| 2020 November | 101 | 28 | 129 |
| 2020 October | 60 | 23 | 83 |
| 2020 September | 89 | 27 | 116 |
| 2020 August | 77 | 25 | 102 |
| 2020 July | 40 | 25 | 65 |
| 2020 June | 32 | 39 | 71 |
| 2020 May | 52 | 24 | 76 |
| 2020 April | 21 | 12 | 33 |
| 2020 March | 18 | 14 | 32 |
| 2020 February | 2 | 0 | 2 |
| 2019 May | 0 | 1 | 1 |
| 2019 February | 5 | 0 | 5 |
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