Follicular basal cell hyperplasia overlying dermatofibroma

Liang Cheng, Saeid B. Amini, M. Tarif Zaim

Research output: Contribution to journalArticle

35 Scopus citations


Follicular basal cell hyperplasia (FBCH) overlying dermatofibroma represents aborted or impeded pilaf differentiation. Historically, this hyperplasia has been misinterpreted as basal cell carcinoma. In a large series of dermatofibroma (258 cases), those that contained primitive or malformed follicular structures over the lesion (59 cases) were compared with those without such elements (199 cases). Statistical analysis of various clinicopathologic features showed that FBCH was significantly associated with younger age, trunk location, hypercellular dermatofibroma, loss of a Grenz zone, clear cell hyperplasia, and seborrheic keratosis-like change. There was an inverse correlation between epidermal atrophy, lichen simplex chronicus- like change, and lower extremity location with FBCH. Histologic features favoring a diagnosis of FBCH over basal cell carcinoma are the focal nature and superficial location of the lesion, lack of cytologic atypia and mitoses, recognizable components of hair follicle differentiation, focal condensation of mesenchymal cells around basal cell proliferation, and the association of epidermal hyperplasia. Our findings suggest that FBCH, clear cell hyperplasia, and seborrheic keratosis-like change all represent an expression of follicular differentiation overlying dermatofibroma.

Original languageEnglish (US)
Pages (from-to)711-718
Number of pages8
JournalAmerican Journal of Surgical Pathology
Issue number6
StatePublished - Jun 1 1997
Externally publishedYes


  • Clear cell hyperplasia
  • Dermatofibroma
  • Follicular basal cell hyperplasia
  • Hair follicle differentiation
  • Seborrheic keratosis

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

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