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Abstract
Introduction: Fibroepithelioma of Pinkus (FeP), a variant of basal cell carcinoma, is often a difficult clinical diagnosis. Common differentials include nevus, skin tag, melanoma, and seborrheic keratosis, illustrating the diversity of clinical presentation [1-2]. Given the benign appearance, the clinical variability, and the paucity of descriptions in the literature, we sought to characterize FeP, compare our cases with previous reports, and raise awareness of this lesion.
Methods: A retrospective analysis of FeP cases 1/1/2010-12/31/2021 at UCSF Dermatopathology was conducted. Demographics, clinical presentation, and relevant medical history were reviewed and compared to other case series.
Results: Thirty cases of FeP were identified. Mean patient age was 67±15 years, 16 (53%) patients were male and 14 (47%) female. 22 (73%) lesions were found on the torso, 4 (13%) on the head and neck, and 4 (13%) on the lower extremities. In clinical notes, most lesions were described as papules or plaques. 16 (53%) patients had previous diagnoses of nonmelanoma skin cancers, and 4 (13%) had history of melanoma - 2 patients had a history of both. 3 (10%) of patients were immunosuppressed at time of biopsy. Analysis of 4 case series [1–4] and our own did not reveal a significant difference in female/male incidence (p=0.6, student’s t test).
Conclusion: Here, we illustrate the variability of FeP and correlate demographics and presentation with previous literature. We report no sexual predilection of FeP, in contrast to previous statements of female preponderance. Also, we find a low incidence of the “classic” polyploid/domed morphologies.