Skin Cancer in Skin of Color

Porcia T. Bradford


Dermatology Nursing. 2009;21(4):170-77; 206. 

In This Article

Dermatofibrosarcoma Protuberans

Dermatofibrosarcoma protuberans (DFSP) is a relatively uncommon tumor with intermediate-to-low grade malignancy (Gloster, 1996) (see Table 6). Although rare, DFSP accounts for about 10% of all cases of skin cancer in Blacks (Halder & Bang, 1988). In a recent review of cutaneous soft tissue tumors, Blacks (6.4 per 1,000,000 person-years) had higher incidence rates of DFSP than Caucasians and Asians (4.4 and 2.7 per 1,000,000 person-years, respectively) (Rouhani et al., 2008).

The cause of DFSP is unknown. There have been cytogenetic studies showing DFSP tumor cells with chromosomal abnormalities. However, the role these cytogenetic aberrations play in the pathogenesis of DFSP is unknown (Gloster, 1996).

The clinical features of DFSP are similar in Blacks, Asians, Hispanics, and Caucasians (see Table 6). DFSP typically presents on the trunk or extremity of adults between 20 and 50 years of age as a violaceous, red-brown, or flesh-colored indurated plaque which, with time, develops protuberant nodules (Halder & Bridgeman-Shah, 1995). It typically ranges in size from 1 cm to 5 cm and is similar in appearance to keloids. Atypical keloids in skin of color, such as those unusual in appearance or occurring in nontraumatized areas of skin or in nontension areas, and keloids with rapid clinical growth, should be biopsied (Halder & Bridgeman-Shah, 1995).

DFSP metastasizes in only 5% of cases (Gloster, 1996), and most commonly disseminates hematogenously to the lungs. Although metastasis rarely occurs, DFSP is a locally aggressive tumor with a high recurrence rate. Treatment for DFSP is primarily Mohs' micrographic surgery (Gloster, 1996).


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