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Atypical Fibroxanthoma Treatment & Management

  • Author: Forrest C Brown, MD; Chief Editor: William D James, MD  more...
Updated: Sep 04, 2015

Surgical Care

In the past, many lesions were diagnosed clinically as pyogenic granuloma and removed by shave and curettage, without recurrence, which has prompted physicians to treat atypical fibroxanthoma (AFX) conservatively. Local recurrence and spread to lymph nodes may occur.[16, 17] This suggests that complete tumor removal is required. Simple excision with a margin of normal skin or Mohs micrographic surgery may be appropriate.

Evidence is accumulating rapidly that demonstrates that Mohs micrographic surgery, with its high reliability of complete tumor removal and tissue-conserving property, may be the treatment of choice for AFX on the head and neck.[18, 19, 20]

Contributor Information and Disclosures

Forrest C Brown, MD Clinical Professor of Dermatology, University of Texas Southwestern Medical School; Section Chief, Department of Dermatology, Medical City Dallas Hospital

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Carrie L Kovarik, MD Assistant Professor of Dermatology, Dermatopathology, and Infectious Diseases, University of Pennsylvania School of Medicine

Carrie L Kovarik, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

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Red, beefy, sessile nodule typical of clinical presentation of atypical fibroxanthoma. Note the markedly sun-damaged skin with solar telangiectasias. Courtesy of Capt James Steger, MC, USN, US Naval Hospital, San Diego.
Microscopic view of atypical fibroxanthoma. Note the large abnormal-appearing cells in a field of spindle cells. Courtesy of Capt James Steger, MC, USN, US Naval Hospital, San Diego.
Table. Antibody Panels in Tumors


Desmin or smooth muscle actinNNNNNR
*Spindle cell malignant melanoma
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