No Results

No Results


Dermatofibroma (superficial benign fibrous histiocytoma) is a common cutaneous nodule of unknown etiology that occurs more often in women. Dermatofibroma frequently develops on the extremities (mostly the lower legs) and is usually asymptomatic, although pruritus and tenderness can be present. It is actually the most common painful skin tumor. [1] A number of well-described, histologic subtypes of dermatofibroma have been reported. Removal of the tumor is usually not typically required unless diagnostic uncertainty exists or particularly troubling symptoms are present.

This article discusses primarily cutaneous (superficial) dermatofibroma. Subcutaneous (deep) benign fibrous histiocytomas are also well documented and may have a more aggressive clinical course, as can tumors displaying cellular, aneurysmal (hemosiderotic), and atypical histologic variants of dermatofibroma.

In addition, benign fibrous histiocytomas are reported in bone, orbital, airway, gastrointestinal, splenic, genitourinary, and intracranial locations.

The precise mechanism for the development of dermatofibroma is unknown. Rather than a reactive tissue change, evidence that dermatofibroma may be a neoplastic process is demonstrated by its clonal proliferative growth. [2] Clonality, by itself, is not necessarily synonymous with a neoplastic process; it has been demonstrated in inflammatory conditions, including atopic dermatitis, lichen sclerosis, and psoriasis. Dermatofibroma tumorigenesis may be due to distorted protein kinase C activity. [3]

Results from immunohistochemical testing with antibodies to factor XIIIa, which label dermal dendritic cells, are frequently positive in dermatofibroma, while antibodies to MAC 387, which label monocyte-derived macrophages (histiocytes), show less consistent results. One study evaluated the expression in dermatofibroma of HSP47, a recently used marker for skin fibroblasts; CD68, a marker for histiocytes; and factor XIIIa. Most of the spindle-shaped cells in all 28 cases of dermatofibroma, irrespective of histologic variant, stained positively with HSP47, indicating that skin fibroblasts are a major constituent of dermatofibroma. Factor XIIIa–positive dendritic cells also are present, but the presence of CD68-positive histiocytes was inconsistent, especially between histologic variants. [4] CD14+ monocytes have been proposed as the cell of origin of dermatofibromas. [5]

The cell surface proteoglycan, syndecan-1, [6] and fibroblast growth factor receptor 2, involved in epithelial-mesenchymal cross-talk, [7] may play a role in the growth of dermatofibromas. Transforming growth factor-beta (TGF-beta) signaling might be a trigger of the fibrosis seen in dermatofibromas. [8] TGF-beta, along with other fibrinogenic factors, may be produced by mast cells, which have been reported to occur in abnormally high numbers in dermatofibromas. [9]

Gene fusions have been described in dermatofibroma tumorigenesis. [10, 11] ALK gene rearrangement and overexpression has been demonstrated in the epithelioid and atypical dermatofibroma variants. [12, 13]

Historically attributed to be a reactive process to some traumatic insult to the skin (eg, arthropod bite, skin tattooing, tuberculin skin testing, prior folliculitis), [14, 15, 16, 17] the cause of dermatofibroma is unknown. Clonal analysis suggest it may represent a true neoplasm. [2]

Altered immunity likely plays a role in many cases of multiple eruptive dermatofibromas associated with various underlying conditions and medications (see History).

A study of eruptive dermatofibromas in a kindred suggests that a genetic component may exist. [18]

Dermatofibromas are relatively common.

Frequency of dermatofibroma appears to be similar in all races.

Females are affected by dermatofibroma more commonly than males, with a male-to-female ratio of 1:2, or higher. [19, 20]

Dermatofibroma can occur in patients of any age. In one series, 80% of biopsy specimens were from patients aged 20-49 years, [19] and in another the mean age of the patients was 42.18±13.72 years. [20]

Typical superficial dermatofibromas are considered benign lesions, and the prognosis for patients with this condition is excellent. However, discomfort from pain or itching may be significant.

Deep, cellular, aneurysmal (hemosiderotic), and atypical variants, which are notoriously more locally recurrent (≤20% of cases), can rarely metastasize. [21, 22, 23] (The deep subset of dermatofibroma that arises in the subcutaneous or deep soft tissue may undergo further classification. [22] ) Such variants, or any indeterminant dermatofibroma, might be regarded as potentially malignant lesions. [24] In these exceptional cases, pulmonary and nodal metastases were most commonly seen, some patients developed multiple satellite nodules, and deaths have occurred. [25] The primary tumors tended to be large and cellular, but aggressive behavior is not entirely predictable, although early or frequent recurrences of the tumor should raise concern. [25] Array-based comparative genomic hybridization (CGH) may prove useful in identifying these higher-risk variants. [26, 27, 22]

The epithelioid variant has also been reported to metastasize, although demonstration of ALK gene rearrangement may indicate it is a biologically distinct tumor. [12]

In a study of common dermatofibromas with an increased mitotic rate but no other worrisome features, none recurred or metastasized. [28]

Spontaneous regression has been reported, [29] and this may yield postinflammatory hypopigmentation, although this appears to be quite rare.

For patient education resources, see the Procedures Center, as well as Mole Removal.

Naversen DN, Trask DM, Watson FH, Burket JM. Painful tumors of the skin: “LEND AN EGG”. J Am Acad Dermatol. 1993 Feb. 28(2 Pt 2):298-300. [Medline].

Chen TC, Kuo T, Chan HL. Dermatofibroma is a clonal proliferative disease. J Cutan Pathol. 2000 Jan. 27(1):36-9. [Medline].

Plaszczyca A, Nilsson J, Magnusson L, Brosjö O, Larsson O, Vult von Steyern F, et al. Fusions involving protein kinase C and membrane-associated proteins in benign fibrous histiocytoma. Int J Biochem Cell Biol. 2014 Apr 8. [Medline].

Kuroda K, Tajima S. Proliferation of HSP47-positive skin fibroblasts in dermatofibroma. J Cutan Pathol. 2008 Jan. 35(1):21-6. [Medline].

Jin SY, Choi JS, Choi YL, Choi YL, Kim do H, Lee SH. Identification of leukocyte-specific protein 1-positive cells: a clue to the cell of origin and a marker for the diagnosis of dermatofibroma. Ann Dermatol. 2015 Apr. 27 (2):157-62. [Medline].

Sellheyer K, Smoller BR. Dermatofibroma: upregulation of syndecan-1 expression in mesenchymal tissue. Am J Dermatopathol. 2003 Oct. 25(5):392-8. [Medline].

Skroza N, Rotolo S, Ceccarelli S, et al. Modulation of the expression of the FGFR2-IIIb and FGFR2-IIIc molecules in dermatofibroma. J Dermatol Sci. 2008 Jul. 51(1):53-7. [Medline].

Kubo M, Ihn H, Yamane K, Tamaki K. The expression levels and the differential expression of transforming growth factor-beta receptors in dermatofibroma and dermatofibrosarcoma protuberans. Br J Dermatol. 2006 May. 154(5):919-25. [Medline].

Yamamoto T. Dermatofibroma: a possible model of local fibrosis with epithelial/mesenchymal cell interaction. J Eur Acad Dermatol Venereol. 2009 Apr. 23(4):371-5. [Medline].

Walther C, Hofvander J, Nilsson J, Magnusson L, Domanski HA, Gisselsson D, et al. Gene fusion detection in formalin-fixed paraffin-embedded benign fibrous histiocytomas using fluorescence in situ hybridization and RNA sequencing. Lab Invest. 2015 Sep. 95 (9):1071-6. [Medline].

Panagopoulos I, Gorunova L, Bjerkehagen B, Lobmaier I, Heim S. LAMTOR1-PRKCD and NUMA1-SFMBT1 fusion genes identified by RNA sequencing in aneurysmal benign fibrous histiocytoma with t(3;11)(p21;q13). Cancer Genet. 2015 Nov. 208 (11):545-51. [Medline].

Doyle LA, Mariño-Enriquez A, Fletcher CD, Hornick JL. ALK rearrangement and overexpression in epithelioid fibrous histiocytoma. Mod Pathol. 2015 Jul. 28 (7):904-12. [Medline].

Szablewski V, Laurent-Roussel S, Rethers L, Rommel A, Van Eeckhout P, Camboni A, et al. Atypical fibrous histiocytoma of the skin with CD30 and p80/ALK1 positivity and ALK gene rearrangement. J Cutan Pathol. 2014 Sep. 41 (9):715-9. [Medline].

Evans J, Clarke T, Mattacks CA, Pond CM. Dermatofibromas and arthropod bites: is there any evidence to link the two?. Lancet. 1989 Jul 1. 2(8653):36-7. [Medline].

Lobato-Berezo A, Churruca-Grijelmo M, Martínez-Pérez M, Imbernón-Moya A, Vargas-Laguna ME, Fernández-Cogolludo E, et al. Dermatofibroma Arising within a Black Tattoo. Case Rep Dermatol Med. 2014. 2014:745304. [Medline].

Watanabe K, Fukuda H, Niiyama S, Oharasaki T, Mukai H. Multiple dermatofibromas subsequent to folliculitis. Eur J Dermatol. 2013 Nov-Dec. 23 (6):890-1. [Medline].

Nomura E, Yamamoto T. Photoletter to the editor: Fibrous histiocytoma developing at the site of tuberculin skin test. J Dermatol Case Rep. 2012 Dec 31. 6 (4):130-1. [Medline].

Samlaska C, Bennion S. Eruptive dermatofibromas in a kindred. Cutis. 2002 Mar. 69(3):187-8, 190. [Medline].

Han TY, Chang HS, Lee JH, Lee WM, Son SJ. A clinical and histopathological study of 122 cases of dermatofibroma (benign fibrous histiocytoma). Ann Dermatol. 2011 May. 23(2):185-92. [Medline].

Şenel E, Yuyucu Karabulut Y, Doğruer Şenel S. Clinical, histopathological, dermatoscopic and digital microscopic features of dermatofibroma: a retrospective analysis of 200 lesions. J Eur Acad Dermatol Venereol. 2015 Oct. 29 (10):1958-66. [Medline].

Kaddu S, McMenamin ME, Fletcher CD. Atypical fibrous histiocytoma of the skin: clinicopathologic analysis of 59 cases with evidence of infrequent metastasis. Am J Surg Pathol. 2002 Jan. 26(1):35-46. [Medline].

Gleason BC, Fletcher CD. Deep “benign” fibrous histiocytoma: clinicopathologic analysis of 69 cases of a rare tumor indicating occasional metastatic potential. Am J Surg Pathol. 2008 Mar. 32(3):354-62. [Medline].

Szumera-Cieckiewicz A, Ptaszynski K. Benign fibrous histiocytoma of the skin metastasizing to the inguinal lymph node. Pol J Pathol. 2011 Sep. 62(3):183-6. [Medline].

Kimyai-Asadi A, Goldberg LH, Greenberg C, et al. Cellular, atypical, and indeterminate dermatofibromas: benign or malignant?. Dermatol Surg. 2008 Sep. 34(9):1264-71; discussion 1271-2. [Medline].

Doyle LA, Fletcher CD. Metastasizing “benign” cutaneous fibrous histiocytoma: a clinicopathologic analysis of 16 cases. Am J Surg Pathol. 2013 Apr. 37 (4):484-95. [Medline].

Charli-Joseph Y, Saggini A, Doyle LA, Fletcher CD, Weier J, Mirza S, et al. DNA copy number changes in tumors within the spectrum of cellular, atypical, and metastasizing fibrous histiocytoma. J Am Acad Dermatol. 2014 Apr 19. [Medline].

Mentzel T, Wiesner T, Cerroni L, Hantschke M, Kutzner H, Rütten A, et al. Malignant dermatofibroma: clinicopathological, immunohistochemical, and molecular analysis of seven cases. Mod Pathol. 2013 Feb. 26 (2):256-67. [Medline].

Fernandez-Flores A, Manjon JA. Mitosis in dermatofibroma: a worrisome histopathologic sign that does not necessarily equal recurrence. J Cutan Pathol. 2008 Sep. 35(9):839-42. [Medline].

Niemi KM. The benign fibrohistiocytic tumours of the skin. Acta Derm Venereol Suppl (Stockh). 1970. 50(63):Suppl 63:1-66. [Medline].

Massone C, Parodi A, Virno G, Rebora A. Multiple eruptive dermatofibromas in patients with systemic lupus erythematosus treated with prednisone. Int J Dermatol. 2002 May. 41(5):279-81. [Medline].

García-Millán C, Aldanondo I, Fernández-Lorente M, Carrillo R, Jaén P. [Multiple eruptive dermatofibromas in 2 patients infected with the human immunodeficiency virus]. Actas Dermosifiliogr. 2007 Dec. 98(10):702-6. [Medline].

Marque M, Pallure V, Huet P, Bessis D, Guillot B. [Multiple familial “eruptive” dermatofibromas]. Ann Dermatol Venereol. 2013 Jun-Jul. 140 (6-7):452-4. [Medline].

Huang PY, Chu CY, Hsiao CH. Multiple eruptive dermatofibromas in a patient with dermatomyositis taking prednisolone and methotrexate. J Am Acad Dermatol. 2007 Nov. 57(5 Suppl):S81-4. [Medline].

Lopez N, Fernandez A, Bosch RJ, Herrera E. Multiple eruptive dermatofibromas in a patient with Graves-Basedow disease. J Eur Acad Dermatol Venereol. 2008 Mar. 22(3):402-3. [Medline].

Kimura Y, Kaneko T, Akasaka E, Nakajima K, Aizu T, Nakano H, et al. Multiple eruptive dermatofibromas associated with Hashimoto’s thyroiditis and myasthenia gravis. Eur J Dermatol. 2010 Jul-Aug. 20(4):538-9. [Medline].

Monteagudo B, Suarez-Amor O, Cabanillas M, et al. [Down syndrome: another cause of immunosuppression associated with multiple eruptive dermatofibromas?]. Dermatol Online J. 2009 Sep 15. 15(9):15. [Medline].

Alexandrescu DT, Wiernik PH. Multiple eruptive dermatofibromas occurring in a patient with chronic myelogenous leukemia. Arch Dermatol. 2005 Mar. 141(3):397-8. [Medline].

Bhattacharjee P, Umar SA, Fatteh SM. Multiple eruptive dermatofibromas occurring in a patient with myelodysplastic syndrome. Acta Derm Venereol. 2005. 85(3):270-1. [Medline].

Zaccaria E, Rebora A, Rongioletti F. Multiple eruptive dermatofibromas and immunosuppression: report of two cases and review of the literature. Int J Dermatol. 2008 Jul. 47(7):723-7. [Medline].

Yazici AC, Baz K, Ikizoglu G, Koca A, Kokturk A, Apa DD. Familial eruptive dermatofibromas in atopic dermatitis. J Eur Acad Dermatol Venereol. 2006 Jan. 20(1):90-2. [Medline].

Beyazit Y, Caner S, Kurt M, Kekilli M, Aydog G, Ibis M. Dermatofibroma in a patient with Crohn’s disease: a novel clinical manifestation. J Crohns Colitis. 2010 Oct. 4(4):490-1. [Medline].

Hiraiwa T, Hanami Y, Yamamoto T. Hidradenitis suppurativa and multiple dermatofibromas in a patient with ulcerative colitis. J Dermatol. 2013 Dec. 40 (12):1071-2. [Medline].

Bachmeyer C, Cordier F, Blum L, Cazier A, Vérola O, Aractingi S. Multiple eruptive dermatofibromas after highly active antiretroviral therapy. Br J Dermatol. 2000 Dec. 143(6):1336-7. [Medline].

Santos-Juanes J, Coto-Segura P, Mallo S, Galache C, Soto J. Multiple eruptive dermatofibromas in a patient receiving efalizumab. Dermatology. 2008. 216(4):363. [Medline].

Caldarola G, Bisceglia M, Pellicano R. Multiple eruptive plaque-like dermatofibromas during anti-TNFa treatment. Int J Dermatol. 2013 May. 52(5):638-41. [Medline].

Llamas-Velasco M, Fraga J, Solano-López GE, Steegmann JL, García Diez A, Requena L. Multiple eruptive dermatofibromas related to imatinib treatment. J Eur Acad Dermatol Venereol. 2014 Jul. 28 (7):979-81. [Medline].

Finch J, Berke A, McCusker M, Chang MW. Congenital Multiple Clustered Dermatofibroma in a 12-Year-Old Girl. Pediatr Dermatol. 2011 Dec 30. [Medline].

Gershtenson PC, Krunic AL, Chen HM. Multiple clustered dermatofibroma: case report and review of the literature. J Cutan Pathol. 2010 Sep. 37(9):e42-5. [Medline].

Fitzpatrick TB, Gilchrest BA. Dimple sign to differentiate benign from malignant pigmented cutaneous lesions. N Engl J Med. 1977 Jun 30. 296(26):1518. [Medline].

Lookingbill DP. A malignant dimple. N Engl J Med. 1977 Oct 13. 297(15):841-2. [Medline].

Meffert JJ, Peake MF, Wilde JL. Dimpling’ is not unique to dermatofibromas. Dermatology. 1997. 195(4):384-6. [Medline].

Requena L, Farina MC, Fuente C, et al. Giant dermatofibroma. A little-known clinical variant of dermatofibroma. J Am Acad Dermatol. 1994 May. 30(5 Pt 1):714-8. [Medline].

Ohnishi T, Sasaki M, Nakai K, Watanabe S. Atrophic dermatofibroma. J Eur Acad Dermatol Venereol. 2004 Sep. 18(5):580-3. [Medline].

Kai H, Fujita H, Yamamoto M, Asahina A. Letter: Polypoid dermatofibroma with a slim pedicle: A case report. Dermatol Online J. 2012 Mar 15. 18(3):16. [Medline].

Curco N, Jucgla A, Bordas X, Moreno A. Dermatofibroma with spreading satellitosis. J Am Acad Dermatol. 1992 Dec. 27(6 Pt 1):1017-9. [Medline].

Kalsi H, Rahman A, Harbol T, Sidhu J. Giant Hemosiderotic Dermatofibroma: The Largest Giant Dermatofibroma Reported to Date. Am J Dermatopathol. 2015 Oct. 37 (10):778-82. [Medline].

Bhabha FK, Magee J, Ng SY, Grills CE, Su J, Orchard D. Multiple clustered dermatofibroma presenting in a segmental distribution. Australas J Dermatol. 2016 Feb. 57 (1):e20-2. [Medline].

Schofield C, Weedon D, Kumar S. Dermatofibroma and halo dermatitis. Australas J Dermatol. 2012 May. 53(2):145-7. [Medline].

Wortsman X, Wortsman J. Clinical usefulness of variable-frequency ultrasound in localized lesions of the skin. J Am Acad Dermatol. 2010 Feb. 62(2):247-56. [Medline].

Picard A, Long-Mira E, Chuah SY, Passeron T, Lacour JP, Bahadoran P. Interest of high-definition optical coherent tomography (HD-OCT) for non-invasive imaging of dermatofibroma: a pilot study. J Eur Acad Dermatol Venereol. 2016 Mar. 30 (3):485-7. [Medline].

Demir MK, Ozdemir H, Genchallaç H, Altaner S, Kartal O. Dermatofibroma mimicking malignancy on integrated F-18 fluorodeoxyglucose PET-CT. Diagn Interv Radiol. 2009 Mar. 15(1):61-3. [Medline].

Zaballos P, Puig S, Llambrich A, Malvehy J. Dermoscopy of dermatofibromas: a prospective morphological study of 412 cases. Arch Dermatol. 2008 Jan. 144(1):75-83. [Medline].

Cavicchini S, Tourlaki A, Tanzi C, Alessi E. Dermoscopy of solitary yellow lesions in adults. Arch Dermatol. 2008 Oct. 144(10):1412. [Medline].

Roldán-Marín R, Barreiro-Capurro A, García-Herrera A, Puig S, Alarcón-Salazar I, Carrera C, et al. Green colour as a novel dermoscopic finding in the diagnosis of haemosiderotic dermatofibroma. Australas J Dermatol. 2013 Jul 19. [Medline].

Ferrari A, Argenziano G, Buccini P, Cota C, Sperduti I, De Simone P, et al. Typical and atypical dermoscopic presentations of dermatofibroma. J Eur Acad Dermatol Venereol. 2013 Nov. 27(11):1375-80. [Medline].

Pereira Guedes RV, Noronha de Menezes NM, Leite IB, Baptista MA. Benign fibrous histiocytoma: Particular aspects on confocal laser scanning microscopy. Eur J Dermatol. 2012 Mar-Apr. 22(2):288-9. [Medline].

Kideryova L, Lacina L, Dvorankova B, et al. Phenotypic characterization of human keratinocytes in coculture reveals differential effects of fibroblasts from benign fibrous histiocytoma (dermatofibroma) as compared to cells from its malignant form and to normal fibroblasts. J Dermatol Sci. 2009 Jul. 55(1):18-26. [Medline].

Nair V, Weinreb I, MacNeil N, Szollosi Z, Chetty R, Ghazarian D. A unique biphasic variant of cutaneous fibrous histiocytoma with a storiform pattern and intralesional pigmented melanocytes: “storiform melano-fibrous histiocytoma”. Eur J Dermatol. 2008 May-Jun. 18(3):332-6. [Medline].

Wick MR, Ritter JH, Lind AC, Swanson PE. The pathological distinction between “deep penetrating” dermatofibroma and dermatofibrosarcoma protuberans. Semin Cutan Med Surg. 1999 Mar. 18(1):91-8. [Medline].

Goldblum JR, Tuthill RJ. CD34 and factor-XIIIa immunoreactivity in dermatofibrosarcoma protuberans and dermatofibroma. Am J Dermatopathol. 1997 Apr. 19(2):147-53. [Medline].

Volpicelli ER, Fletcher CD. Desmin and CD34 positivity in cellular fibrous histiocytoma: an immunohistochemical analysis of 100 cases. J Cutan Pathol. 2012 Aug. 39 (8):747-52. [Medline].

John AM, Holahan HH, Singh P, Handler MZ, Lambert WC. When Immunohistochemistry Deceives Us: The Pitfalls of CD34 and Factor XIIIa Stains in Dermatofibroma and Dermatofibrosarcoma Protuberans. Skinmed. 2017. 15 (1):53-55. [Medline].

Borucki R, Perry DM, Lopez-Garcia DR, Kazlouskaya V, Elston DM. Fluorescence microscopy for the evaluation of elastic tissue patterns within fibrous proliferations of the skin on hematoxylin-eosin-stained slides. J Am Acad Dermatol. 2018 Jan 5. [Medline].

Kim HJ, Lee JY, Kim SH, et al. Stromelysin-3 expression in the differential diagnosis of dermatofibroma and dermatofibrosarcoma protuberans: comparison with factor XIIIa and CD34. Br J Dermatol. 2007 Aug. 157(2):319-24. [Medline].

Maekawa T, Jinnin M, Ihn H. The expression levels of thrombospondin-1 in dermatofibroma and dermatofibrosarcoma protuberans. Eur J Dermatol. 2011 Jul-Aug. 21(4):534-8. [Medline].

Li J, Yu Y, Yang Y, Wang L, Cao J, Liang X, et al. IGFBP7, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans. J Eur Acad Dermatol Venereol. 2012 Mar. 26(3):382-5. [Medline].

Mori T, Misago N, Yamamoto O, Toda S, Narisawa Y. Expression of nestin in dermatofibrosarcoma protuberans in comparison to dermatofibroma. J Dermatol. 2008 Jul. 35(7):419-25. [Medline].

Wang L, Xiang YN, Zhang YH, Tu YT, Chen HX. Collagen triple helix repeat containing-1 in the differential diagnosis of dermatofibrosarcoma protuberans and dermatofibroma. Br J Dermatol. 2011 Jan. 164(1):135-40. [Medline].

Bandarchi B, Ma L, Marginean C, Hafezi S, Zubovits J, Rasty G. D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans. Mod Pathol. 2010 Mar. 23(3):434-8. [Medline].

Yan X, Takahara M, Xie L, Tu Y, Furue M. Cathepsin K expression: a useful marker for the differential diagnosis of dermatofibroma and dermatofibrosarcoma protuberans. Histopathology. 2010 Sep. 57(3):486-8. [Medline].

Toyozawa S, Yamamoto Y, Ishida Y, Kondo T, Nakamura Y, Furukawa F. Immunohistochemical analysis of CXCR4 expression in fibrohistiocytic tumors. Acta Histochem Cytochem. 2010 May 1. 43(2):45-50. [Medline]. [Full Text].

Horenstein MG, Prieto VG, Nuckols JD, Burchette JL, Shea CR. Indeterminate fibrohistiocytic lesions of the skin: is there a spectrum between dermatofibroma and dermatofibrosarcoma protuberans?. Am J Surg Pathol. 2000 Jul. 24(7):996-1003. [Medline].

Wang WL, Patel KU, Coleman NM, et al. COL1A1:PDGFB chimeric transcripts are not present in indeterminate fibrohistiocytic lesions of the skin. Am J Dermatopathol. 2010 Apr. 32(2):149-53. [Medline].

Ishigami T, Hida Y, Matsudate Y, Murao K, Kubo Y. The involvement of fibroblast growth factor receptor signaling pathways in dermatofibroma and dermatofibrosarcoma protuberans. J Med Invest. 2013. 60(1-2):106-13. [Medline].

Kazlouskaya V, Malhotra S, Kabigting FD, Lal K, Elston DM. CD99 expression in dermatofibrosarcoma protuberans and dermatofibroma. Am J Dermatopathol. 2014 May. 36(5):392-6. [Medline].

Mentzel T. Cutaneous mesenchymal tumours: an update. Pathology. 2014 Feb. 46(2):149-59. [Medline].

West KL, Cardona DM, Su Z, Puri PK. Immunohistochemical markers in fibrohistiocytic lesions: factor XIIIa, CD34, S-100 and p75. Am J Dermatopathol. 2014 May. 36(5):414-9. [Medline].

Mikoshiba Y, Ogawa E, Uchiyama R, Uchiyama A, Uhara H, Okuyama R. 5-Hydroxymethylcytosine is a useful marker to differentiate between dermatofibrosarcoma protuberans and dermatofibroma. J Eur Acad Dermatol Venereol. 2016 Jan. 30 (1):130-1. [Medline].

Karanian M, Pérot G, Coindre JM, Chibon F, Pedeutour F, Neuville A. Fluorescence in situ hybridization analysis is a helpful test for the diagnosis of dermatofibrosarcoma protuberans. Mod Pathol. 2015 Feb. 28 (2):230-7. [Medline].

Kaur H, Kaur J, Gill KS, Mannan R, Arora S. Subcutaneous dermatofibroma: a rare case report with review of literature. J Clin Diagn Res. 2014 Apr. 8 (4):FD01-2. [Medline].

Zelger BG, Zelger B. [Dermatofibroma. A clinico-pathologic classification scheme]. Pathologe. 1998 Nov. 19(6):412-9. [Medline].

Deguchi M, Aiba S. Cholesterotic Fibrous Histiocytoma in a Patient with Metabolic Syndrome. Case Rep Dermatol. 2017 May-Aug. 9 (2):136-140. [Medline].

Zelger BG, Sidoroff A, Zelger B. Combined dermatofibroma: co-existence of two or more variant patterns in a single lesion. Histopathology. 2000 Jun. 36(6):529-39. [Medline].

Gonzalez-Vela MC, Val-Bernal JF, Martino M, Gonzalez-Lopez MA, Garcia-Alberdi E, Hermana S. Sclerotic fibroma-like dermatofibroma: an uncommon distinctive variant of dermatofibroma. Histol Histopathol. 2005 Jul. 20(3):801-6. [Medline].

Alves JV, Matos DM, Barreiros HF, Bártolo EA. Variants of dermatofibroma – a histopathological study. An Bras Dermatol. 2014 Jun. 89(3):472-7. [Medline]. [Full Text].

McCalmont TH. Everything you wanted to know about dermatofibroma but were afraid to ask. J Cutan Pathol. 2014 Jan. 41(1):5-8. [Medline].

de Feraudy S, Mar N, McCalmont TH. Evaluation of CD10 and procollagen 1 expression in atypical fibroxanthoma and dermatofibroma. Am J Surg Pathol. 2008 Aug. 32(8):1111-22. [Medline].

Sanchez Yus E, Soria L, de Eusebio E, Requena L. Lichenoid, erosive and ulcerated dermatofibromas. Three additional clinico-pathologic variants. J Cutan Pathol. 2000 Mar. 27(3):112-7. [Medline].

Aiba S, Terui T, Tagami H. Dermatofibroma with diffuse eosinophilic infiltrate. Am J Dermatopathol. 2000 Jun. 22(3):281-4. [Medline].

Aydin E, Vardareli OS, Bilezikci B, Ozgirgin ON. [Dermatofibroma accompanied by perforating dermatosis in the auricle: a case report]. Kulak Burun Bogaz Ihtis Derg. 2005. 15(3-4):83-6. [Medline].

Kim EJ, Park HS, Yoon HS, Cho S. A case of perforating dermatofibroma with floret-like giant cells. Clin Exp Dermatol. 2015 Apr. 40 (3):305-8. [Medline].

Fuciarelli K, Cohen PR. Sebaceous hyperplasia: a clue to the diagnosis of dermatofibroma. J Am Acad Dermatol. 2001 Jan. 44(1):94-5. [Medline].

Spaun E, Zelger B. Dermatofibroma with intracytoplasmic eosinophilic globules: an unusual phenomenon. J Cutan Pathol. 2009 Jul. 36(7):796-8. [Medline].

Garrido-Ruiz MC, Carrillo R, Enguita AB, Peralto JL. Signet-ring cell dermatofibroma. Am J Dermatopathol. 2009 Feb. 31(1):84-7. [Medline].

Quigley BC, Ricciuti J, Morgan MB. Amyloid Light Chain Deposition Associated with Dermatofibroma: Serendipity or Association?. Am J Dermatopathol. 2010 Jan 23. [Medline].

Yamamoto T. Incidental acantholysis of the overlying epidermis of dermatofibroma. J Eur Acad Dermatol Venereol. 2009 Jun. 23(6):735-6. [Medline].

Gonzalez S. Regarding the case report of Dr Phillip W. Allen on apocrine gland cyst with hemosiderotic dermatofibroma. Adv Anat Pathol. 2008 Nov. 15(6):376; author reply 376. [Medline].

Santos-Briz A, Llamas-Velasco M, Arango L, Yuste M, Paredes BE, Kutzner H. Cutaneous adenodermatofibroma: report of 2 cases. Am J Dermatopathol. 2013 Aug. 35(6):e103-5. [Medline].

Kanitakis J. Keloidal dermatofibroma: report of a rare dermatofibroma variant in a young white woman. Am J Dermatopathol. 2013 May. 35(3):400-1. [Medline].

Schnebelen AM, Brown JA, Cheung WL, Hiatt KM, Smoller BR. Collapsing angiokeloidal dermatofibroma. Am J Dermatopathol. 2012 Oct. 34(7):e103-5. [Medline].

Famenini S, Cassarino DS. Dermatofibroma-associated dystrophic calcification. J Cutan Pathol. 2014 Jan. 41(1):68-70. [Medline].

Baderca F, Mates I, Solovan C. Unusual variant of blue nevus associated with dermatofibromas. Rom J Morphol Embryol. 2013. 54(2):413-7. [Medline].

Maughan C, Kolker S, Markus B, Young J. Leukemia cutis coexisting with dermatofibroma as the initial presentation of B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma. Am J Dermatopathol. 2014 Jan. 36(1):e14-5. [Medline].

Morcos SM, Girardi M, Subtil A, Wilson LD, Cowper SE. Mycosis fungoides exhibiting features of a dermatofibroma: a case report and review of the literature. J Cutan Pathol. 2012 Jan. 39(1):40-6. [Medline].

Zeidi M, North JP. Sebaceous induction in dermatofibroma: a common feature of dermatofibromas on the shoulder. J Cutan Pathol. 2015 Jun. 42 (6):400-5. [Medline].

King R, Googe PB, Page RN, Mihm MC Jr. Melanocytic lesions associated with dermatofibromas: a spectrum of lesions ranging from junctional nevus to malignant melanoma in situ. Mod Pathol. 2005 Aug. 18(8):1043-7. [Medline].

Shin J, Vincent JG, Cuda JD, Xu H, Kang S, Kim J, et al. Sox10 is expressed in primary melanocytic neoplasms of various histologies but not in fibrohistiocytic proliferations and histiocytoses. J Am Acad Dermatol. 2012 Oct. 67(4):717-26. [Medline].

Kovach BT, Boyd AS. Melanoma associated with a dermatofibroma. J Cutan Pathol. 2007 May. 34(5):420-2. [Medline].

Orrock JM, Abbott JJ, Gibson LE, Folpe AL. INI1 and GLUT-1 expression in epithelioid sarcoma and its cutaneous neoplastic and nonneoplastic mimics. Am J Dermatopathol. 2009 Apr. 31(2):152-6. [Medline].

Kim HJ, Kim IH. A 3-mm margin completely removes dermatofibromas: a study of 151 cases. Dermatol Surg. 2015 Feb. 41 (2):283-6. [Medline].

Halim K, Karia PS, Schmults CD. Aneurysmal dermatofibroma successfully treated with Mohs micrographic surgery. Dermatol Surg. 2015 Jan. 41 (1):168-70. [Medline].

Weber PJ, Moody BR, Foster JA. Inverted pyramidal biopsy. Dermatol Surg. 2001 Jul. 27(7):681-4. [Medline].

Krupa Shankar DS, Kushalappa AA, Suma KS, Pai SA. Multiple dermatofibromas on face treated with carbon dioxide laser. Indian J Dermatol Venereol Leprol. 2007 May-Jun. 73(3):194-5. [Medline].

Alonso-Castro L, Boixeda P, Segura-Palacios JM, de Daniel-Rodríguez C, Jiménez-Gómez N, Ballester-Martínez A. Dermatofibromas treated with pulsed dye laser: Clinical and dermoscopic outcomes. J Cosmet Laser Ther. 2012 Apr. 14(2):98-101. [Medline].

Joseph C Pierson, MD Dermatology Residency Program Director, University of Vermont College of Medicine

Joseph C Pierson, MD is a member of the following medical societies: Association of Professors of Dermatology, New England Dermatological Society, American Academy of Dermatology

Disclosure: Nothing to disclose.

Christine C Tam, MD Managing Member, Certified Dermatologists

Christine C Tam, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society for MOHS Surgery, Association of Military Dermatologists, Phi Beta Kappa

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Diane Pierson, DO, to the development and writing of this article.


Research & References of Dermatofibroma|A&C Accounting And Tax Services