Core Dermatology Diagnoses / CategoriesNeoplastic Benign and Malignant

Dermatofibroma

Author: Faculty Reviewer:

Publish date: Posted on
Last updated: November 27, 2024

Keywords #
  • dermatofibroma
  • benign fibrous histiocytoma
  • common fibrous histiocytoma
  • solitary histiocytoma
  • sclerosing hemangioma
Diagnosis #

Dermatofibromas, otherwise known as fibrous histiocytomas, are benign subcutaneous nodules resulting from fibroblast proliferation. Dermatofibromas are typically found on the extremities as 5-12 mm papules or nodules; and patients often have a history minor of trauma to the area.[1] It is undetermined if dermatofibromas are a clonal neoplasm (favored) or caused by an inflammatory etiology.[2]  They are typically asymptomatic and may regress spontaneously — though this is uncommon.[1,3]

Key Concepts #
  • Dermatofibromas are benign subcutaneous nodules.
  • They often occur at a skin site with past history of minor trauma.[1]
  • Typically asymptomatic in nature, dermatofibromas grow slowly to 5 -2 mm.
  • Their pathogenesis is unknown but clonal proliferation is favored.[2]
Epidemiology #

Dermatofibromas occur more often in females than males. The lesions are most commonly acquired between 20 to 40 years of age; however, they can be found in people of all ages.[1]

Clinical Features #
  • Often presents as a well circumscribed, flesh-colored to reddish-brown papule.[4]
  • The “lateral dimple sign” is positive.[3]
  • Dermatofibromas typically present as a single lesion but can be multiple.
  • If numerous lesions are found, suspect immune suppression.[5]
Differential Diagnoses #
Diagnostic Workup #

No diagnostic workup is indicated for dermatofibromas as it is considered a clinical diagnosis.[1]  Punch or shave biopsy can be obtained for a clinically equivocal or significantly changing lesion.

Treatment #

No treatment is required. Excision, intralesional steroid injection, or laser can be performed for cosmetic purposes or if the lesion is symptomatic.[3,7]

Slide Viewer #
https://utahderm.med.utah.edu/image-viewer/
References #
  1. Myers, David, and Eric P. Fillman. Dermatofibroma. StatPearls Publishing, 2020.
  2. Vanni, Roberta, et al. “Cytogenetic evidence of clonality in cutaneous benign fibrous histiocytomas: a report of the CHAMP study group.” Histopathology 37, 2000, pp. 212-217.
  3. Wolff, Klaus, et al. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology. McGraw-Hill Education, 2017. Print.
  4. Han, Tae Young, et al. “A clinical and histopathological study of 122 cases of dermatofibroma (benign fibrous histiocytoma).” Annals of Dermatology vol 23, 2011, pp. 185-192.
  5. Newman, Dennis and J.B. Walter. “Multiple dermatofibromas in patients with systemic lupus erythematous on immunosuppressive therapy.” New England Journal of Medicine 289, 1973, pp. 842-843.
  6. Marks, James and Jeffrey Miller. Lookingbill and Marks’ Principles of Dermatology. Elsevier, 2019. Print.
  7. Higgins, James, et al. “Diagnosing Common Benign Skin Tumors.” American Family Physician 92, no. 7, 2015, pp. 601-607.
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