Atypical Fibroxanthoma

By Gregory L. Wells, MD, Dartmouth Medical School and Dartmouth-Hitchcock Medical Center

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Atypical fibroxanthoma is a low-grade sarcoma of the skin.

(See also Overview of Skin Cancer.)

Atypical fibroxanthomas most commonly occur on the head and neck of elderly patients. They appear similar to other nonmelanoma skin cancers, as nonhealing or tender pink-red skin papules or nodules.

Diagnosis is with biopsy.

Tumors are excised, or Mohs micrographic surgery—in which tissue borders are progressively excised until specimens are tumor-free (as determined by microscopic examination during surgery)—is done if clinically appropriate. Metastasis is unusual.

Prevention

Because atypical fibroxanthomas seem to be related to ultraviolet (UV) exposure, a number of measures are recommended to limit exposure.

Sun avoidance: Seeking shade, minimizing outdoor activities between 10 am and 4 pm (when sun's rays are strongest), and avoiding sunbathing and the use of tanning beds
Use of protective clothing: Long-sleeved shirts, pants, and broad-brimmed hats
Use of sunscreen: At least sun protection factor (SPF) 30 with broad-spectrum UVA/UVB protection, used as directed (ie, reapplied every 2 h and after swimming or sweating); should not be used to prolong sun exposure