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Dermatofibroma is a benign fibrous nodule that commonly affects the lower legs. An overview of its features, diagnosis, and treatment options is provided.
A dermatofibroma is defined as a benign fibrous nodule that mainly affects the skin on the lower legs. It occurs in all age groups; however, the prevalence is higher in women than in men.
It has not been established whether dermatofibroma should be classified as a neoplasm or simply a reactive process. These lesions are made up of proliferating fibroblasts. Histiocytes can also play a role.
Dermatofibroma usually develops in the areas of the legs and arms, but can also affect the trunk and other body sites.
The clinical features of dermatofibroma are quite distinct. Affected individuals on average have from 1 to 15 lesions. The size of a lesion can vary from 0.5 to 1.5 cm, but the majority of lesions are from 7 to 10 mm in diameter. They appear as immovable firm nodules on the surface of the skin and as mobile nodules in the subcutaneous tissue. The colour may appear as pink or light brown on fair skin and as dark brown or black on darker skin. The lesions are usually asymptomatic, but some patients report experiencing pain and itching.
Since dermatofibroma can appear as a raised lesion, it can be easily traumatized on a daily basis and during everyday activities, such as by a razor.
Quite often, dozens of dermatofibroma lesions can erupt within a couple of months due to immunosuppression caused by medications, cancer, or autoimmune disease.
Dermatofibroma does not progress into cancer. However, in some cases, it can be mistaken for desmoplastic melanoma.
Dermatofibroma is easy to diagnose due to its distinct features. The examination is usually performed via dermatoscopy. The most commonly observed dermatoscopic pattern is a central white area surrounded by a lightly pigmented network. A skin biopsy or diagnostic excision may be performed if atypical features such as ulceration, enlargement, or asymmetrical structures are observed during examination.
A dermatofibroma is a harmless skin lesion and does not typically present any symptoms. The lesion can be removed surgically if it causes discomfort or concern; however, it has a tendency to reoccur.
Cryotherapy, laser treatment, and shave biopsy can be incorporated into a treatment plan to reduce dermatofibroma.
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