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Nodular Subepidermal Fibrosis: A Clinical Pathologic Study Emphasizing the Frequency of Clinical Misdiagnoses

Nodular Subepidermal Fibrosis: A Clinical Pathologic Study Emphasizing the Frequency of Clinical... Abstract Nodular subepidermal fibrosis is a relatively common benign skin lesion. However, at Barnes Hospital (St. Louis) the correct diagnosis is made clinically in less than 30% of the excised lesions. Further, in nearly 10% of our cases, the clinical appearance prompted a diagnosis of some form of skin cancer. A clinicopathologic study of 610 lesions is presented to re-emphasize the existence of nodular subepidermal fibrosis, and its clinical and biological features. The fact that four diagnostic synonyms are currently employed by pathologists reflects uncertainty regarding the etiology and histogenesis of nodular subepidermal fibrosis. The terms "dermatofibroma"1 and "sclerosing hemangioma"2 are at least as commonly applied as "nodular subepidermal fibrosis,"3 while "histiocytoma"4 is sometimes preferred. The nature of the lesion (neoplastic vs reactive-reparative) and the basic cell involved (histiocyte vs fibroblast vs endothelial) are debated. Whatever their origin, the biologic behavior of these small asymptomatic lesions is References 1. Sahrens, H.T.: Dermatofibroma Lenticulare: Fibroma Simplex (Unna); Noduli Cutanei (Arming and Lewandowsky) Arch Derm Syph 161:456-468, 1920. 2. Gross, R.E., and Wolbach, S.B.: Sclerosing Hemangiomas: Their Relationship to Dermatofibroma, Histiocytoma, Xanthoma, and to Certain Pigmented Lesions of the Skin , Amer J Path 19:533-551 ( (July) ) 1943. 3. Michelson, H.E.: Nodular Subepidermal Fibrosis , Arch Derm Syph 27:812-820 ( (May) ) 1933.Crossref 4. Woringer, F.: Histiocytome Xanthelasimise du Mollet , Bull Soc Franc Derm Syph 38:401-405, 1931. 5. Halpryn, H.J., and Allen, A.C.: Epidermal Changes Associated With Sclerosing Hemangiomas , Arch Derm 80:160-166 ( (Feb) ) 1959.Crossref 6. Ackerman, L.V.: Surgical Pathology , ed 3, St. Louis: C. V. Mosby Co., 1964, pp 105-106. 7. Rentiers, P.L., and Montgomery, H.: Nodular Subepidermal Fibrosis (Dermatofibroma Versus Histiocytoma) , Arch Derm Syph 59:568-583 ( (May) ) 1949.Crossref 8. Lever, W.F.: Histiopathology of the Stain , ed 4, Philadelphia: J. P. Lippincott, Co., 1967, pp 616-619. 9. Lund, H.Z.: Tumors of the Skin; Atlas of Tumor Pathology , Washington, DC: Armed Forces Institute of Pathology, 1957, pp 274, 285-291. 10. Dawson, E.K.: Sclerosing Angioma: a Non-Melanotic Pigmented Tumor of the Skin , Edinburgh Med J 55:655-674, 1948. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Nodular Subepidermal Fibrosis: A Clinical Pathologic Study Emphasizing the Frequency of Clinical Misdiagnoses

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Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1969.01340090072009
Publisher site
See Article on Publisher Site

Abstract

Abstract Nodular subepidermal fibrosis is a relatively common benign skin lesion. However, at Barnes Hospital (St. Louis) the correct diagnosis is made clinically in less than 30% of the excised lesions. Further, in nearly 10% of our cases, the clinical appearance prompted a diagnosis of some form of skin cancer. A clinicopathologic study of 610 lesions is presented to re-emphasize the existence of nodular subepidermal fibrosis, and its clinical and biological features. The fact that four diagnostic synonyms are currently employed by pathologists reflects uncertainty regarding the etiology and histogenesis of nodular subepidermal fibrosis. The terms "dermatofibroma"1 and "sclerosing hemangioma"2 are at least as commonly applied as "nodular subepidermal fibrosis,"3 while "histiocytoma"4 is sometimes preferred. The nature of the lesion (neoplastic vs reactive-reparative) and the basic cell involved (histiocyte vs fibroblast vs endothelial) are debated. Whatever their origin, the biologic behavior of these small asymptomatic lesions is References 1. Sahrens, H.T.: Dermatofibroma Lenticulare: Fibroma Simplex (Unna); Noduli Cutanei (Arming and Lewandowsky) Arch Derm Syph 161:456-468, 1920. 2. Gross, R.E., and Wolbach, S.B.: Sclerosing Hemangiomas: Their Relationship to Dermatofibroma, Histiocytoma, Xanthoma, and to Certain Pigmented Lesions of the Skin , Amer J Path 19:533-551 ( (July) ) 1943. 3. Michelson, H.E.: Nodular Subepidermal Fibrosis , Arch Derm Syph 27:812-820 ( (May) ) 1933.Crossref 4. Woringer, F.: Histiocytome Xanthelasimise du Mollet , Bull Soc Franc Derm Syph 38:401-405, 1931. 5. Halpryn, H.J., and Allen, A.C.: Epidermal Changes Associated With Sclerosing Hemangiomas , Arch Derm 80:160-166 ( (Feb) ) 1959.Crossref 6. Ackerman, L.V.: Surgical Pathology , ed 3, St. Louis: C. V. Mosby Co., 1964, pp 105-106. 7. Rentiers, P.L., and Montgomery, H.: Nodular Subepidermal Fibrosis (Dermatofibroma Versus Histiocytoma) , Arch Derm Syph 59:568-583 ( (May) ) 1949.Crossref 8. Lever, W.F.: Histiopathology of the Stain , ed 4, Philadelphia: J. P. Lippincott, Co., 1967, pp 616-619. 9. Lund, H.Z.: Tumors of the Skin; Atlas of Tumor Pathology , Washington, DC: Armed Forces Institute of Pathology, 1957, pp 274, 285-291. 10. Dawson, E.K.: Sclerosing Angioma: a Non-Melanotic Pigmented Tumor of the Skin , Edinburgh Med J 55:655-674, 1948.

Journal

Archives of SurgeryAmerican Medical Association

Published: Mar 1, 1969

References