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" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 23 | 12 | 35 |
| 2024 Octubre | 166 | 76 | 242 |
| 2024 Septiembre | 166 | 58 | 224 |
| 2024 Agosto | 206 | 108 | 314 |
| 2024 Julio | 243 | 77 | 320 |
| 2024 Junio | 185 | 64 | 249 |
| 2024 Mayo | 173 | 62 | 235 |
| 2024 Abril | 157 | 45 | 202 |
| 2024 Marzo | 163 | 43 | 206 |
| 2024 Febrero | 197 | 39 | 236 |
| 2024 Enero | 169 | 41 | 210 |
| 2023 Diciembre | 196 | 20 | 216 |
| 2023 Noviembre | 249 | 39 | 288 |
| 2023 Octubre | 251 | 36 | 287 |
| 2023 Septiembre | 215 | 47 | 262 |
| 2023 Agosto | 268 | 29 | 297 |
| 2023 Julio | 188 | 45 | 233 |
| 2023 Junio | 205 | 26 | 231 |
| 2023 Mayo | 326 | 29 | 355 |
| 2023 Abril | 198 | 32 | 230 |
| 2023 Marzo | 199 | 31 | 230 |
| 2023 Febrero | 175 | 42 | 217 |
| 2023 Enero | 176 | 32 | 208 |
| 2022 Diciembre | 162 | 40 | 202 |
| 2022 Noviembre | 121 | 24 | 145 |
| 2022 Octubre | 121 | 25 | 146 |
| 2022 Septiembre | 141 | 43 | 184 |
| 2022 Agosto | 118 | 27 | 145 |
| 2022 Julio | 80 | 36 | 116 |
| 2022 Junio | 69 | 32 | 101 |
| 2022 Mayo | 159 | 46 | 205 |
| 2022 Abril | 220 | 38 | 258 |
| 2022 Marzo | 184 | 49 | 233 |
| 2022 Febrero | 161 | 30 | 191 |
| 2022 Enero | 203 | 47 | 250 |
| 2021 Diciembre | 194 | 53 | 247 |
| 2021 Noviembre | 219 | 65 | 284 |
| 2021 Octubre | 233 | 77 | 310 |
| 2021 Septiembre | 213 | 50 | 263 |
| 2021 Agosto | 198 | 50 | 248 |
| 2021 Julio | 212 | 28 | 240 |
| 2021 Junio | 156 | 39 | 195 |
| 2021 Mayo | 206 | 56 | 262 |
| 2021 Abril | 475 | 63 | 538 |
| 2021 Marzo | 214 | 45 | 259 |
| 2021 Febrero | 158 | 48 | 206 |
| 2021 Enero | 156 | 30 | 186 |
| 2020 Diciembre | 136 | 29 | 165 |
| 2020 Noviembre | 101 | 28 | 129 |
| 2020 Octubre | 60 | 23 | 83 |
| 2020 Septiembre | 89 | 27 | 116 |
| 2020 Agosto | 77 | 25 | 102 |
| 2020 Julio | 40 | 25 | 65 |
| 2020 Junio | 32 | 39 | 71 |
| 2020 Mayo | 52 | 24 | 76 |
| 2020 Abril | 21 | 12 | 33 |
| 2020 Marzo | 18 | 14 | 32 |
| 2020 Febrero | 2 | 0 | 2 |
| 2019 Mayo | 0 | 1 | 1 |
| 2019 Febrero | 5 | 0 | 5 |
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