Dermoscopy Patterns of Fibroepithelioma of Pinkus

Abstract

Background: Fibroepithelioma of Pinkus (FeP) is a rare variant of basal cell carcinoma that may clinically mimic a number of benign skin tumors. While the dermoscopic features of basal cell carcinoma have been studied extensively, little is known about the dermoscopic features of FeP.Observations: Retrospective evaluation of clinical records and digital clinical dermoscopic images of 10 histopathologically proved FePs (6 nonpigmented and 4 pigmented) was performed. Clinically, no FeP was correctly identified and, in half of all patients, a clinical differential diagnosis of purely benign skin lesions was made. Dermoscopy enabled the correct diagnosis in 9 of 10 FePs, based on the presence of fine arborizing ves-sels, either alone or associated with dotted vessels, and white streaks (in 100%, 70%, and 90% of lesions, respectively). In the 4 pigmented FePs, a structureless gray-brown area of pigmentation and variable numbers of gray-blue dots were observed, in addition.Conclusions: Dermoscopy is helpful in diagnosing FeP and in differentiating this variant of basal cell carcinoma from other benign skin tumors commonly included in the clinical differential diagnosis. This presumes, however, that dermoscopy is used as a first-line examination for all skin lesions, not only for those that are clinically suspect.

Fibroepithelioma of Pinkus: Dermoscopic and reflectance confocal microscopic patterns

“…The dermoscopic pattern of FeP is commonly represented by white streaks and fine arborizing vessels, either alone or in combination with dotted vessels, with ulceration and milia-like cysts rarely observed. 7 Our case exhibited vascular polymorphism and lacked ulceration or milia-like cysts, confirming previous findings. The specific pattern is recognizable during RCM examination due to the presence of tumoral cords with peripheral palisading arranged in a peculiar fenestrated pattern, which corresponds well to the histologic features of FeP.…”

Unusual presentation of basal cell carcinoma with fibroepithelioma‐like histology in two patients with Gorlin syndrome

“…FeP is described to show fine arborising vessels alone or with dotted vessels, white streaks, and in some cases gray-blue structureless areas and dots on dermoscopic examination. 5 However, we were not able to detect any of the mentioned dermoscopic features for our cases. Therefore, it was a Historically HS has been treated by many different specialties but owned by none.…”

Shiny white streaks: An additional dermoscopic finding in melanomas viewed using contact polarised dermoscopy

“…Conversely, only rarely did benign melanocytic lesions exhibit SWS (1.3% of cases). While SWS cannot be deemed to be a melanoma‐specific criteria (as similar criteria have also been observed in dermatofibromas, scars, basal cell carcinomas (including Pinkus' fibroepithelioma variant) and pyogenic granulomas, 8–10 we believe SWS could be used as an additional dermoscopic feature, allowing the discrimination of benign versus malignant melanocytic skin lesions. In addition, based on the relationship between the presence of SWS and mean Breslow thickness, identification of SWS could be added to the other criteria as a useful guide for the preoperative identification of thicker melanomas 15,16 …”

“…In a recent study, an additional dermoscopic feature, shiny white streaks (SWS), was described in some melanomas examined under polarised light contact dermoscopy 7 . Similar criteria have also been observed in other lesions, such as dermatofibromas, scars, basal cell carcinomas (included Pinkus' fibroepithelioma variant) and pyogenic granulomas; 8–10 however, to the best of our knowledge, SWS have not yet been described in naevi.…”