Morphea-like Epithelioma

Morpheaform Basal‐Cell Epitheliomas

“…Our 51 patients were almost equally men and women, which makes our group different from those of previous studies, in which there were preponderances of women (see Table 1). 1–3 The average age of our patients was 57.5 years, with a range from 30 to 89 years. No patient had more than one morpheaform basal‐cell epithelioma and in 38 (75%) that one was the only skin cancer on them.…”

“…Solar elastosis on the face and neck sometimes appears as localized plaques 2 . The cicatrizing basal‐cell epithelioma is a variant of the nodulo ulcerative type 11,12 and is distinguishable from the morpheaform lesion by history, biologic behavior, and clinical appearance 3 . It is usually a large, diffuse lesion with advancing, raised, nodular borders around atrophic, sclerotic, ulcerated or crusted areas.…”

“…The histologic appearance of the morpheaform basal‐cell epithelioma is important in that it aids understanding its gross morphology, obscure clinical margins, and resistance to treatment by conventional methods 2 . The characteristic pattern is that of numerous infiltrating strands and cords of cells that vary from small aggregations to one or two cells embedded in dense, concentrically arranged fibrous stroma 3,13 . This fibrous stroma is an aspect of the neoplasm that probably represents an exaggerated and abnormal reaction of stroma to abnormal epithelial proliferation as worked out by Pinkus 14 and Van Scott 15…”

“…Howell and Caro 3 found that the natural course of the morpheaform basal‐cell epithelioma varies from that of a seemingly benign, torpid neoplasm in most cases to an invasive, destructive, and dangerous malignancy on occasion. Litzow et al 1 report only two of their thirteen cases as having been invasive (Table 1), one of which became invasive only after two excisions and repair by a graft.…”

“…The extent is clinically indistinct, making it extremely difficult to assess the true extent of the lesion by either sight or touch. This characteristic may lead to delay in diagnosis and inadequate treatment 1–3 …”