Atypical fibroxanthoma are a rare type of skin cancer generally seen in older adults with mean age of presentation 69 years. They are thought to be due to excessive sun exposure or ionizing radiation exposure. They are more common in patients with a history of suppressed immune systems such as transplant patients or those with HIV. They can occur anywhere on the body, but most commonly arise on the head and neck. They can appear as a red, dome shaped nodule that develops quickly, the majority of patients seem evaluated in 6 months. Diagnosis is achieved with a skin biopsy and may require the pathologist to use special tests called immunohistochemical stains to identify this type of tumor. Atypical fibroxanthoma can ulcerated or have a crusted appearance. Metastasis or spread of AFX to other organs can occur but is rare.
Atypical Fibroxanthoma can be prevented by avoiding sun during peak hours 10am- 4pm, wearing sunscreen daily with repeat applications while outdoors, and/ or wearing protective clothing.
Preventative skin exams are recommended to help diagnose and treat these areas.
Removal of the skin cancer either by wide local excision or Mohs micrographic surgery especially in cosmetically sensitive areas on the face or ears.