Basal cell carcinomas and basal cell carcinoma-like changes overlying dermatofibromas.

Three patients had pigmented nodular basal cell carcinomas overlying dermatofibromas and 19 patients had basal cell carcinoma-like changes. We agree with the view generally held that acanthosis, pseudoepitheliomatous hyperplasia, basal cell buddings, and hair follicle-like proliferations of basal cells represent reactive changes of a spectrum of epidermal alterations overlying dermatofibromas. Contrary to the general opinion, however, we believe that basal cell carcinoma-like changes, superficial multicentric basal cell carcinomas, and nodular basal cell carcinomas represent neoplastic changes of such a spectrum.