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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case Report</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 76-year-old patient complained an asymptomatic lesion for more than 6 months&#44; consisting of a normochromic plaque on the lower back&#44; somewhat papillomatous with a slightly erythematous center &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; with peripheral white striae and microulcerations on dermoscopy &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Histopathological examination showed an epithelial basaloid proliferation with a focally reticulate pattern &#40;<a class="elsevierStyleCrossRefs" href="#fig0015">Figs&#46; 3 and 4</a>&#41;&#46; The excision of the lesion was performed&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">What&#8217;s your diagnosis&#63;</span><p id="par0010" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a&#41;</span><p id="par0015" class="elsevierStylePara elsevierViewall">Seborrheic keratosis</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b&#41;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Fibroepithelioma of Pinkus</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c&#41;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Superficial basal cell carcinoma</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">d&#41;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Trichoblastoma</p></li></ul></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Fibroepithelioma of Pinkus &#40;FeP&#41; is considered an uncommon type of basal cell carcinoma &#40;BCC&#41;&#44; first described by Hermann Pinkus in 1953&#44; who named it a premalignant variant of basal cell epithelioma&#44; and similar to trichoblastomas regarding their degrees of differentiation&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Therefore&#44; some researchers have claimed that both BCC and trichoblastomas can be better classified as opposing representatives of the same spectrum of differentiation&#44; with FeP deserving an intermediate classification within this fine line&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">It is more often reported in females &#40;54&#37;&#41; and the elderly<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and is probably underreported&#46; It presents clinically as normochromic&#47;brown single or multiple lesions&#44; such as papules or plaques&#44; dome-shaped or sessile&#44; which can mimic benign skin lesions that would not be routinely excised or biopsied&#44; such as pedunculated fibroma&#44; acrochordon&#44; seborrheic keratosis&#44; and dermal nevus&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> It affects non-photoexposed areas such as the lumbosacral and abdominal region&#44; groin&#44; and foot&#46; On dermoscopy&#44; thin branched vessels&#44; punctiform vessels&#44; white septal striae&#44; corneal pseudocysts&#44; and ulcerations are observed&#46; Some lesions show structureless gray-brown pigmentation and bluish-gray dots&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Histopathological examination is crucial for the diagnosis as it reveals thin strands of basaloid cells surrounded by stroma&#44; which form a uniform border with the underlying dermis in a fenestrated&#44; honeycomb-like pattern&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Treatment consists of the surgical excision of the lesion&#46; The prognosis is good&#44; with low local aggressiveness and low risk for metastasis&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Regarding the above mentioned differential diagnoses&#44; seborrheic keratosis is a benign&#44; rounded&#44; or irregular lesion with a brownish or black color&#44; affecting mainly the face and trunk&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Superficial basal cell carcinoma more commonly affects the face and neck&#44; presents wide branched vessels on dermoscopy&#44; and is less differentiated on histopathology&#44; not fenestrated&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Trichoblastoma is a rarer tumor&#44; with fine arboriform vessels&#44; crown vessels&#44; and pearly white background on dermoscopy&#44; with a fibrocystic stroma&#44; formation of follicular bulbs and papillae on histopathology&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;8</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Financial support</span><p id="par0060" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Authors&#8217; contributions</span><p id="par0070" class="elsevierStylePara elsevierViewall">Nicole Baldin&#58; Drafting and editing of the manuscript&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Gabriela Galv&#227;o Santos&#58; Drafting and editing of the manuscript&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Paulo Ricardo Martins Souza&#58; Drafting and editing of the manuscript&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Laura Luzzatto&#58; Anatomopathological evaluation&#59; intellectual participation in the propaedeutic conduct&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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What is your diagnosis?
Case for diagnosis. Fibroepithelioma of Pinkus in a 76-year-old patient
Nicole Baldina,
Corresponding author
nicolebaldin2@gmail.com

Corresponding author.
, Gabriela Galvão Santosb, Paulo Ricardo Martins Souzab, Laura Luzzattob
a Faculty of Medicine, Universidade Franciscana, Santa Maria, RS, Brazil
b Dermatology Outpatient Clinic, Hospital Santa Casa de Misericórdia em Porto Alegre, Porto Alegre, RS, Brazil
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case Report</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 76-year-old patient complained an asymptomatic lesion for more than 6 months&#44; consisting of a normochromic plaque on the lower back&#44; somewhat papillomatous with a slightly erythematous center &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; with peripheral white striae and microulcerations on dermoscopy &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Histopathological examination showed an epithelial basaloid proliferation with a focally reticulate pattern &#40;<a class="elsevierStyleCrossRefs" href="#fig0015">Figs&#46; 3 and 4</a>&#41;&#46; The excision of the lesion was performed&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">What&#8217;s your diagnosis&#63;</span><p id="par0010" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a&#41;</span><p id="par0015" class="elsevierStylePara elsevierViewall">Seborrheic keratosis</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b&#41;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Fibroepithelioma of Pinkus</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c&#41;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Superficial basal cell carcinoma</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">d&#41;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Trichoblastoma</p></li></ul></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Fibroepithelioma of Pinkus &#40;FeP&#41; is considered an uncommon type of basal cell carcinoma &#40;BCC&#41;&#44; first described by Hermann Pinkus in 1953&#44; who named it a premalignant variant of basal cell epithelioma&#44; and similar to trichoblastomas regarding their degrees of differentiation&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Therefore&#44; some researchers have claimed that both BCC and trichoblastomas can be better classified as opposing representatives of the same spectrum of differentiation&#44; with FeP deserving an intermediate classification within this fine line&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">It is more often reported in females &#40;54&#37;&#41; and the elderly<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and is probably underreported&#46; It presents clinically as normochromic&#47;brown single or multiple lesions&#44; such as papules or plaques&#44; dome-shaped or sessile&#44; which can mimic benign skin lesions that would not be routinely excised or biopsied&#44; such as pedunculated fibroma&#44; acrochordon&#44; seborrheic keratosis&#44; and dermal nevus&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> It affects non-photoexposed areas such as the lumbosacral and abdominal region&#44; groin&#44; and foot&#46; On dermoscopy&#44; thin branched vessels&#44; punctiform vessels&#44; white septal striae&#44; corneal pseudocysts&#44; and ulcerations are observed&#46; Some lesions show structureless gray-brown pigmentation and bluish-gray dots&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Histopathological examination is crucial for the diagnosis as it reveals thin strands of basaloid cells surrounded by stroma&#44; which form a uniform border with the underlying dermis in a fenestrated&#44; honeycomb-like pattern&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Treatment consists of the surgical excision of the lesion&#46; The prognosis is good&#44; with low local aggressiveness and low risk for metastasis&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Regarding the above mentioned differential diagnoses&#44; seborrheic keratosis is a benign&#44; rounded&#44; or irregular lesion with a brownish or black color&#44; affecting mainly the face and trunk&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Superficial basal cell carcinoma more commonly affects the face and neck&#44; presents wide branched vessels on dermoscopy&#44; and is less differentiated on histopathology&#44; not fenestrated&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Trichoblastoma is a rarer tumor&#44; with fine arboriform vessels&#44; crown vessels&#44; and pearly white background on dermoscopy&#44; with a fibrocystic stroma&#44; formation of follicular bulbs and papillae on histopathology&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;8</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Financial support</span><p id="par0060" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Authors&#8217; contributions</span><p id="par0070" class="elsevierStylePara elsevierViewall">Nicole Baldin&#58; Drafting and editing of the manuscript&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Gabriela Galv&#227;o Santos&#58; Drafting and editing of the manuscript&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Paulo Ricardo Martins Souza&#58; Drafting and editing of the manuscript&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Laura Luzzatto&#58; Anatomopathological evaluation&#59; intellectual participation in the propaedeutic conduct&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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Article information
ISSN: 03650596
Original language: English
DOI:10.1016/j.abd.2021.08.009
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