In many cases, dermatofibromas are asymptomatic. However, the following are the signs and symptoms may be present:
- Dermatofibromas usually develop as single nodules mostly in the lower legs.
- These are firm to touch, whereas some nodules may also get hard.
- These measure 0.5–1 cm in diameter similar to size of a small lentil.
- The surface of the affected skin can appear scaly. The overlying skin can get tethered.
- The size of the nodule tends to remain intact after the initial growth.
- The affected area is tender to touch and can cause pain and itchiness in some cases.
- When touched, the nodule may appear to be freely moving and feels like pebble.
- The affected area can turn grey, pink, orange, red, purple, blue, black or brown in color.
- Atypical variants may present similarly with melanoma, vascular tumors and psoriasis .
Entire Body System
Here, we present a distinct dermatofibroma variant henceforth known as collapsing angiokeloidal dermatofibroma identified in 2 patients with slowly growing nodules of the buttock and the arm. [ncbi.nlm.nih.gov]
Although it is benign, itching and pain can be a source of severe discomfort. der·ma·to·fi·bro·ma ( der'mă'tō-fī-brō'mă ), A slowly growing benign skin nodule consisting of poorly demarcated cellular fibrous tissue enclosing collapsed capillaries, with [medical-dictionary.thefreedictionary.com]
Definition (MSH) A slowly growing benign skin nodule consisting of poorly demarcated cellular fibrous tissue enclosing collapsed CAPILLARIES with scattered HEMOSIDERIN-pigmented and lipid MACROPHAGES. [fpnotebook.com]
No pressure was used to avoid the collapse of the vessels in the lesions. All dermatofibromas were collected prospectively in a period of 3 years (from January 1, 2003, to January 1, 2006). [jamanetwork.com]
Careful examination of the nodule forms the basis of the diagnosis. A pinch test is performed that gives an idea about the nature of the fibromas. In this test, the area of the lesion is squeezed from the sides which causes dimpling of the overlying skin.
A biopsy of the fibroma may be required if the above tests do not give any definite conclusion. The use of Positron Emission Tomography (PET) with radiotracer FDG can demonstrate dermatofibroma within the chest wall effectively .
- Lymphocytic Infiltrate
The occurrence of a halo of dermatitis surrounding acquired naevi was initially reported by Meyerson in 1971 with histological features of focal spongiosis, parakeratosis, irregular acanthosis and a lymphocytic infiltrate in the upper dermis. [ncbi.nlm.nih.gov]
infiltrate can sometimes be observed. 8 Individual collagen bundles surrounded by a dense collagen matrix (“collagen trapping”) are diagnostic. 1,8 The overlying epidermis often is hyperplastic and hyperpigmented in the basal cell layer (dirty fingernail [consultant360.com]
All dermatofibromas were characterized as a poorly circumscribed proliferation of spindle-shaped fibroblasts or histiocytes arranged in sheets or interlocking strands with a storiform pattern, entrapment of collagen bundles, and patchy lymphocyte infiltrates [ijdvl.com]
Dermatofibromas usually do not require any treatment. These do not go away by themselves and therefore, individuals may want to get it removed for cosmetic purposes. In addition, certain individuals may also experience pain and pruritus and may thus want to get rid of it. These nodules are harmless and do not cause any life threatening conditions. The following are the procedures employed for removing:
- Elliptical excision or punch biopsy is the most desired method as the chances of recurrence of the nodule after such procedures is rare.
- Methods such as shave excision or cryotherapy present high risk of recurrence.
- Carbon dioxide laser treatment for multiple dermatofibroma lesions .
Dermatofibromas are benign in nature and usually harmless. They stay for several years together without causing much of problem. Rare variants of dermatofibroma like the atypical, aneurysmal and cellular variants can rarely metastasize though . These variants have an average recurrent rate of 20% . Such a condition does not turn fatal and the prognosis is generally good with treatment. However, in certain cases, the nodules can grow back even post treatment. The success rate of the treatment procedures vary with the type of method employed to remove the growth.
Dermatofibromas usually do not give rise to any complications. The growth been benign in nature does not cause harm to the individual. In rare cases, fibromas can cause the following complications:
Dermatofibromas are a common condition mostly affecting the women than men with the ration of women to men of 4:1. Such a condition can strike women at any age with the incidence rates higher in the younger population.
Dermatofibromas rarely affect children. A statistical study show that dermatofibromas are diagnosed within the age group of 20-49 years old in 80% of cases .
The exact mechanism behind the development of dermatofibromas is still unclear. However, by studying the nature of the fibrous growth it appears than such a condition occurs due to a neoplastic process rather than a reactive tissue change . It can also occur due to distorted protein kinase activity . In majority of the cases, dermatofibromas appear as a single nodule. But, in some cases it may develop into several nodules and is most common in individuals with a suppressed immune system. Dermatofibromas are also associated with the following disease conditions:
- Systemic lupus erythematosus
- Down syndrome
- Graves’ disease
- Multiple myeloma
- Crohn disease
- Atopic dermatitis
- Myasthenia gravis
- Myelodysplastic syndrome
- Cutaneous T–cell lymphoma
Individuals with the above mentioned diseases may also develop dermatofibromas as a secondary complication.
So far no methods have been developed for preventing the occurrence of dermatofibromas. Since the etiology behind the development of such a condition is unclear, there is no way its onset can be prevented.
Dermatofibroma also known as superficial benign fibrous histiocytoma is a benign tumor that develops on the skin’s surface. It is also regarded a clonal proliferative tumor due to its distinct methylation patterns seen in the polymorphic X chromosomes .
The common site for such benign fibrous growth is the lower legs. In addition, they can also occur in the bone, gastrointestinal tract, airways, genitourinary and intracranial locations. This condition typically affects more women than men.
Dermatofibromas can stay for several years and not produce any symptoms. These are harmless growth characterized by firm nodules that are yellow–brown in color. Dermatofibromas are considered the most common painful tumor in man . In dark colored individuals, the nodules may appear even pink in color.
Dermatofibromas are defined as development of small fibrous growth on the skin surface. These are benign in nature and harmless. This is a common condition and is in no way associated with cancers of the skin. Usually these growths are not painful and do not cause any discomfort. Dermatofibromas usually develop as single growth on the skin surface; whereas in some cases, it may present as multiple growth.
Dermatofibromas measure about 0.5–1 cm in diameter. The affected area turns pink, brown, black or red in color. The area is tender to touch and may cause pain and itchiness in some cases. When the nodule is touched it feels like pebble and is freely movable.
The examination of the nodule is usually the first diagnostic procedure. The fibrous growth is observed under a dermatoscope. A typical nodule appears as a group of pigmented network with white patch in the center region. A biopsy of the nodule may be required when no appropriate diagnosis can be made.
Dermatofibromas usually do not require any treatment unless individuals want to get it removed for cosmetic purpose. In addition, such nodules may be a cause of great discomfort requiring immediate removal. The method of punch biopsy is preferred over cryotherapy as with the former procedure the rate of recurrence of the nodule is very rare.
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