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Fibroepithelioma of Pinkus - Skin
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Fibroepithelioma of Pinkus - Skin

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Contributors: Stanley Chan MD, Sylvia Hsu MD, Jeffrey D. Bernhard MD, Noah Craft MD, PhD, Lindy P. Fox MD, Lowell A. Goldsmith MD, MPH, Michael D. Tharp MD
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Synopsis

Fibroepithelioma of Pinkus (FEP) is a rare variant of basal cell carcinoma (BCC) characterized by a slow, indolent clinical course. The lesion classically presents as a solitary pink plaque on the lower back; however, it may present in a variety of forms. Multiple dome-shaped papules and giant pedunculated tumors ranging in color from nonpigmented to brown have been reported. Cystic, pleomorphic, eroded, and giant type variants of FEP have been described.

FEP, like BCC, is seen with increasing frequency in individuals greater than 50 years of age. While FEP is thought to be a variant of BCC, the tumor displays some unique characteristics. Unlike BCC, FEP is more common in females than in males. It is also seen on the lower back on non-sun-exposed skin, suggesting that UV light may have less of a role in its pathogenesis. Some have suggested that FEP would be best classified as a benign counterpart of BCC, such as a trichoblastoma.

Pediatric Patient Considerations:
BCC are extremely uncommon in children without predisposing conditions. However, FEP has been described in an otherwise healthy child as young as 3 years of age.

Codes

ICD10CM:
C44.91 – Basal cell carcinoma of skin, unspecified

SNOMEDCT:
254703005 – Fibroepithelioma of Pinkus

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Trichoblastoma – skin-colored papule on the face, commonly the nose, or upper trunk.
  • Acrochordon – pedunculated skin-colored papule often seen in the axillae and at the base of the neck.
  • Amelanotic melanoma – a melanoma largely lacking pigment; often misdiagnosed initially. Usually presents as a pink papulonodule or tumor.
  • Compound nevus – well-circumscribed, round, tan to brown papule.
  • Neurofibroma – skin-colored soft or rubbery papule or nodule.
  • Seborrheic keratosis – "stuck-on"-appearing verrucous papule that can range from skin colored to brown.

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 06/10/2016
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Fibroepithelioma of Pinkus - Skin
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Fibroepithelioma of Pinkus : Pedunculated papule, Verrucous scaly plaque
Clinical image of Fibroepithelioma of Pinkus
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