Nodular Subepidermal Fibrosis

Some observations on the diagnosis of clinically pigmented skin tumours

“…Number of Lesions.-The tumour is typically single, but multiple growths of the same type at widely differing sites are by no means infrequent. (Michelson, 1933. ) Site.-The sclerosing angioma is most often found on the extremities and there is a striking tendency for it to occur in situations where the risk of frequent injury is considerable.…”

“…Although typically firm, it may be in part compressible. It is seldom tender-when fully grown the tumour seems for long periods, amounting even to years, to remain unchanged, but a few are said to undergo retrogressive changes and to be represented in the end by no more than a scarcely detectable or even by a slightly depressed scar (Michelson, 1933). As to the frequency of such MANAGEMENT I. Diagnosis.-With the non-pigmented tumour we are not, in this discussion, primarily concerned, and we shall content ourselves with noting that it may be mistaken for a xanthorna, the fatty skin tumour of frequent occurrence, or for the more rare cutaneous leiomyoma.…”

“…In such cases there was vascular granulation tissue with numerous fibroblasts just beneath the ulcerated surface, but one could recognize the typical whorled arrangement of the spindle cells around compressed capillaries. When non-pigmented, the resemblance to fibroma may be very close and the more cellular ones mistaken for fibrosarcomas (Michelson, 1933). Dawson (1950) has come across several examples where the original diagnosis has been fibrosarcoma.…”

Cutaneous Lymphoblastoma

“…Fibrosis was also the probable cause of the spontaneous involution of the m entioned small tum our in the first patient; on the site of a previous tum our only a hard dermo-hypodermal mass, the size of pea, on clinical examination easily passing for " nodular subepidemal fibro sis" , was present. An inflamm atory process often precedes the latter condition; spontaneous involution occasionally occurs in it, leaving a somewhat atrophic scar [7]. It is to be supposed th at the spontaneous disappearance of the tum our was the result of the progressive fibrosis with possible oblit eration of the tum our cells -a similar mechanism being involved in the healing phase of another, but benign, " reticulosis"-sarcoidosis.…”

Multiple Noduli Cutanei

“…Rather, we wish to report a case of cutaneous nodules because of certain noteworthy and uncommon features and findings, namely: (1) the large number of nodules present; (2) the unusual clinical aspects of some of the tumefactions; (3) the fact that the patient and her daughter have cutaneous nodules and both had hydronephrosis which required operative intervention; (4) sensitivity to cytotoxic agents upon tissue-culture preparations of a representative lesion.…”