Abstract: Atrophic dermatofibrosarcoma protuberans is a rare subtype of dermatofibrosarcoma protuberans. It differs from classic dermatofibrosarcoma protuberans in clinical manifestations and histopathological features, thus easily leading to misdiagnosis. Herein we report one case. A 25-year-old female patient presented with a painless and itchless erythema on the left chest for 2 years. Histopathology revealed mild epidermal atrophy, massive proliferation of basophilic spindle cells in the dermis and subcutaneous adipose tissue arranged in fascicular or wavy patterns parallel to the epidermis, accompanied by dermal atrophy and upward displacement of subcutaneous fat tissue. Immunohistochemistry results showed positive expression of Vimentin (Vim) and CD34, with Ki-67 proliferation index of approximately 1%-2%. The patient received wide local surgical resection, and No recurrence was observed during the 4-year follow-up.

Key words: atrophic type, dermatofibrosarcoma protuberans, dermoscopy, reflectance confocal laser scanning microscopy