Abstract
29-year-old male presented for evaluation of multiple irritated areas within an epidermal nevus on his back. Examination revealed a lightly erythematous velvety plaque containing multiple discrete scaling papules on the central lower back. One foci of irritation was biopsied and resulted as fibroepithelioma of pinkus. At suture removal, five additional scouting punch biopsies were taken of which three resulted as superficial and nodular basal cell carcinoma and two were consistent with an epidermal nevus. Various medical and surgical treatment options were discussed with the patient. At the time of this write up, the patient has yet to decide on treatment. While malignant transformation arising in sebaceous, dysplastic, and basal cell nevi is well-reported, there are only a few case reports of single or multiple basal cell carcinomas arising in an epidermal nevus. Although the relationship between basal cell carcinoma and fibroepithelioma of pinkus is well-documented, it is unclear if there is a clonal relation or an unknown shared genetic molecular alteration between basal cell carcinoma, fibroepithelioma of pinkus, and epidermal nevus. To our knowledge, this is the first report of a fibroepithelioma of pinkus arising in an epidermal nevus.