Highlighting a histopathological dilemma: atypical dermatofibrosarcoma protuberans diagnosed with multimodal dermoscopy

Abstract An adult male agricultural worker presented with an asymptomatic, heterogeneously pigmented, indurated nodule featuring multiple protuberances on the left pelvic skin. Cross-polarized dermoscopy revealed pink structureless areas and a hyperpigmented reticular network; yellow light dermoscopy accentuated the pigmentary network and entangling vasculature. Ultraviolet-induced fluorescence dermoscopy demonstrated blue–white autofluorescence of surface keratin and milky-white fluorescence of the collagenous/myxoid stroma. Histopathology showed a monomorphic spindle-cell infiltrate without atypia; immunohistochemistry (IHC) confirmed a CD34-positive, S100-negative spindle-cell neoplasm consistent with a myxoid variant of dermatofibrosarcoma protuberans. This case highlights the diagnostic utility of multimodal dermoscopy integrated with histopathology and supportive IHC in precisely evaluating atypical cutaneous tumours.