Atypical Fibroxanthoma

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AFX is one of the more recognizable skin cancers that can affect the body. It is characterized by the sudden development of a red or pink  bump, nodule, or dome shaped ulcer. It is typically found on the head and neck of elderly patients with skin damage from over exposure to UV rays. Because of their rapid growth, pinpointing AFX and promptly treating it is critical to your health. A delay in treatment cause cause a worsening of the condition and may result in complications around the areas of the ear, eye, or nose. 

Signs of Atypical Fibroxanthoma

AFX will most commonly appear on the head and neck of elderly patients. Elderly men develop AFX more frequently than elderly woman. There are several reasons for these generalizations, one being that sunscreen recommendations have only been a mainstream phenomenon since the 1960s, and as a result, seniors may have been exposed to a lot of ultraviolet radiation when they were children. The second reason being that, in the youth of these seniors, men may have spent more time outside than women. AFX can also be found on the torso (especially if a patient has a history of sunbathing or indoor tanning) and on the arms and legs. AFX is primarily caused by sun damage. 


AFX is most often characterized as having the following physical characteristics:


  • Rapid onset (a few days or weeks)


  • Occurs on heavily sun exposed or sun damaged areas


  • Red or pink in color


  • Raised bump, nodule, or ulcer


  • Occasional bleeding

Diagnosis And Treatment

If a surgeon suspects the presence of AFX he or she will likely take a biopsy of the lesion for further evaluation. If it is determined that AFX is present, the recommended treatment options are wide local excision, a surgical procedure that removes an area of cancerous or diseased tissue, or Mohs Micrographic Surgery, a surgical procedure performed by a specialist in a dermatologic setting.


Mohs Micrographic Surgery differs from wide local excision in that it removes skin cancer one small layer at a time. Each layer removed is then analyzed under a microscope until there is no longer a presence of cancerous skin cells. Depending on the size of the area affected, reconstructive surgery by a plastic surgeon may be necessary. This will ensure that the skin heals to the best of its ability, with less chance of scarring. 

Prevention and Detection



Since AFX is directly associated with overly sun damaged skin, the best way to practice prevention is to practice sun safety. Avoid the sun at peak hours, especially if you have particularly sensitive or fair skin that burns easily, use sunblock every two hours, wear a hat, sunglasses, and long sleeves whenever possible, and do not participate in indoor tanning. Keeping your skin healthy for as long as possible is your best bet against skin cancer. 





At home skin exams should occur monthly. This includes skin examinations for children and elderly family members in the household. Being aware of the signs of AFX and other skin cancers is your best bet for early detection and cure. 

Concerned about a new or developing skin lesion?

If you are concerned about a new or developing skin lesion, contact one of our dermatologists today!

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