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April 1992

A Localized Atrophic Plaque on the Back

Author Affiliations

Department of Dermatology, Indiana University Medical Center, Indianapolis

Arch Dermatol. 1992;128(4):552. doi:10.1001/archderm.1992.01680140133020

REPORT OF A CASE  A 25-year-old white man was referred to the dermatology clinic for evaluation of an asymptomatic, slowly enlarging plaque located on the posterior aspect of his left shoulder. The plaque was first noticed approximately 8 years ago and had been examined by several physicians, who felt the lesion was not of concern; thus, no treatment was rendered.On examination, a 2.5×1.5-cm firm, violaceous, slightly depressed lesion was noted superior to the left scapula. Adjacent to this firm area was an atrophic-appearing area of the lesion that was less pigmented and more depressed (Fig 1).A 3-mm punch biopsy specimen was taken from the lesion and is shown in Figs 2 and 3.What is your diagnosis?

DIAGNOSIS:  Dermatofibrosarcoma protuberans (DFSP) (atrophic variant).

HISTOPATHOLOGIC FINDINGS  The tumor was composed predominantly of cells with large spindle-shaped nuclei embedded within collagen and had a

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