Three patients had pigmented nodular basal cell carcinomas overlying dermatofibromas and 19 patients had basal cell carcinoma-like changes. We agree with the view generally held that acanthosis, pseudoepitheliomatous hyperplasia, basal cell buddings, and hair follicle-like proliferations of basal cells represent reactive changes of a spectrum of epidermal alterations overlying dermatofibromas. Contrary to the general opinion, however, we believe that basal cell carcinoma-like changes, superficial multicentric basal cell carcinomas, and nodular basal cell carcinomas represent neoplastic changes of such a spectrum.
Goette DK, Helwig EB. Basal Cell Carcinomas and Basal Cell Carcinoma-like Changes Overlying Dermatofibromas. Arch Dermatol. 1975;111(5):589-592. doi:10.1001/archderm.1975.01630170047005