Affiliation:
1. University of Texas Health Science Center at San Antonio Long School of Medicine San Antonio Texas USA
2. Department of Dermatology Yokota Air Force Base Japan
3. Department of Dermatology San Antonio Uniformed Services Health Education Consortium Houston Texas USA
4. Texas Dermatology and Laser Specialists San Antonio Texas USA
5. Sagis Diagnostics Houston Texas USA
Abstract
AbstractFibroblastic connective tissue nevus (FCTN) is a rare, benign dermal mesenchymal lesion of fibroblastic and myofibroblastic lineage. We report a case of a 2‐year‐old male who presented with an 18‐month history of an erythematous, asymptomatic, unchanging dermal plaque on the right medial frontal scalp. A punch biopsy showed a disorderly, bland, dermal fibroblastic spindle cell proliferation extending to the superficial subcutis. It stained positive for CD34, and concern for dermatofibrosarcoma protuberans was raised. However, FISH was negative for PDGFB rearrangement, and the constellation of findings was most consistent with FCTN. This case underscores the importance of distinguishing CD34+ mesenchymal tumors for both dermatologists and dermatopathologists. As these represent a rather diverse group of lesions with different biological behaviors, a knowledge of the differential diagnosis of these entities is critical for proper patient management.