Outcomes of atypical fibroxanthoma treated with mohs surgery or wide local excision: A retrospective review.

Cohort studyDermatology online journal· May 2026

Outcomes of atypical fibroxanthoma treated with mohs surgery or wide local excision: A retrospective review.

Kevin Varghese, William Liakos, Atieh Jibbe

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Dermatologic SurgeryCohort studyTreatmentQ3IF 0.4

Mohs surgery was linked to smaller surgical defects than wide excision for atypical fibroxanthoma.

Outcomes of atypical fibroxanthoma treated with mohs surgery or wide local excision: A retrospective review.

Kevin Varghese … Atieh Jibbe

Dermatology online journal · May 2026 · Q3 in Dermatology

Background

Atypical fibroxanthoma (atypical fibroxanthoma) is a rare cutaneous spindle cell neoplasm that typically affects elderly men on sun-exposed sites.

Purpose

This study evaluated recurrence, metastasis, and surgical outcomes of atypical fibroxanthoma treated with mohs micrographic surgery versus wide local excision, with emphasis on immunosuppression as a prognostic factor.

Methods

A retrospective review was performed of 23 patients with histologically confirmed atypical fibroxanthoma treated at a single academic center from 2010 to 2024.

n = 23 patients

Results

3.1

cm versus 5.5 cm

Mohs surgery left much smaller wounds than wide excision

n = 23 patients

More results

Fourteen patients underwent mohs micrographic surgery and 9 underwent wide local excision.

Recurrence rates were similar between groups (14% versus 11%).

However, all recurrences and the single metastasis occurred in immunosuppressed patients, who had a higher recurrence rate than immunocompetent patients (67% versus 5%; P = .10).

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Conclusion

Mohs micrographic surgery provided effective tumor clearance with tissue conservation. Immunosuppression was strongly associated with adverse outcomes, underscoring the need for close surveillance in this high-risk subgroup.

Outcomes of atypical fibroxanthoma treated with mohs surgery or wide local excision: A retrospective review.

Outcomes of atypical fibroxanthoma treated with mohs surgery or wide local excision: A retrospective review.

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