Atypical Fibroxanthoma
Also known as: AFX
Low-grade tumor on severely sun-damaged skin. Typically the scalp of elderly men. Excellent prognosis with excision.
What to look for
Side-by-side comparison
Normal scalp
No rapid nodules
AFX
Fast-growing pink nodule
Atypical fibroxanthoma is a low-grade dermal tumor on severely sun-damaged skin, most commonly the head and neck of elderly patients.
It presents as a rapidly growing dome-shaped pink to red nodule that may ulcerate. Can resemble SCC, BCC, or melanoma clinically - biopsy with immunohistochemistry is required.
Despite alarming microscopic appearance, AFX behaves in a low-grade fashion. Metastasis is extremely rare with complete excision. However, it must be distinguished from undifferentiated pleomorphic sarcoma (UPS), which is more aggressive.
Quick self-check
Does this look like atypical fibroxanthoma? Answer 2 questions.
Is it a rapidly growing dome on the head or scalp?
Is surrounding skin severely sun-damaged?
Risk factors
- Severe chronic sun damage
- Age over 70
- Fair skin
- Immunosuppression
- Previous radiation therapy
When to see a dermatologist
- ⚠A rapidly growing pink or red nodule on sun-damaged head or neck skin
- ⚠Any growing dome-shaped scalp lump
- ⚠An ulcerating nodule in an elderly patient
Often confused with
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Is AFX dangerous?
AFX has excellent prognosis when completely excised. Metastasis is extremely rare. But it must be distinguished from undifferentiated pleomorphic sarcoma which looks similar but is more aggressive.