[Atypical fibroxanthoma]

Atypical fibroxanthoma is a rare, malignant skin tumor, mainly affecting elderly, photoexposed men. It accounts for less than 0.2% of skin cancers, and manifests as an erythematous or fleshy nodule, often on the head and neck. Diagnosis is based on anatomopathological analysis, requiring immunostaining to exclude its main differential diagnosis, pleomorphic dermal sarcoma. Extension workup should include ultrasound of lymph node drainage areas. Treatment is based on surgery, with two options: wide excision with 2cm margins, or Mohs micrographic surgery, which reduces recurrence. Recurrences generally occur within the first two years, requiring regular follow-up. Radiotherapy is not recommended. Despite its metastatic potential, appropriate surgical treatment usually ensures a good prognosis.