Basal cell carcinomas and basal cell carcinoma-like changes overlying dermatofibromas

Area of Science:

• Dermatopathology
• Oncology

Background:

• Dermatofibromas are common benign skin tumors.
• The relationship between dermatofibromas and basal cell carcinoma (BCC) is debated.
• Epidermal alterations overlying dermatofibromas can mimic BCC.

Purpose of the Study:

• To investigate the nature of basal cell carcinoma-like changes overlying dermatofibromas.
• To differentiate between reactive and neoplastic changes in these lesions.

Main Methods:

• Histopathological examination of skin lesions.
• Analysis of clinical and pathological features of 22 patients with dermatofibromas and overlying BCC or BCC-like changes.

Main Results:

• Three patients presented with pigmented nodular basal cell carcinomas overlying dermatofibromas.
• Nineteen patients exhibited basal cell carcinoma-like changes.
• Acanthosis, pseudoepitheliomatous hyperplasia, basal cell buddings, and hair follicle-like proliferations were considered reactive epidermal changes.
• Basal cell carcinoma-like changes, superficial multicentric BCC, and nodular BCC were interpreted as neoplastic changes.

Conclusions:

• The spectrum of epidermal alterations overlying dermatofibromas includes both reactive and neoplastic changes.
• Certain basal cell carcinoma-like changes, particularly multicentric and nodular forms, represent true neoplastic proliferation rather than reactive phenomena.