An Atrophic Plaque with Arborizing Vessels

Abstract

Dermatofibromas are a common finding in the daily clinical practice. Most lesions are found incidentally or because patients seek medical attention due to the aspect of the lesion. Rare variants of dermatofibroma such as aneurismatic or atrophic dermatofibroma can be encountered simultaneously; thus, these combined features may raise the possibility of other diagnoses to be considered. By providing diverse clinical and dermoscopic examples of dermatofibromas, we may prevent misdiagnosing these lesions. This case illustrates how two rare variants of dermatofibroma can coexist. Clinical presentation of dermatofibromas may vary greatly, and it is essential for dermatologists to recognize them clinically and dermoscopically before obtaining histopathological diagnosis.

Atrophic Dermatofibroma: A Comprehensive Literature Review

“…Atrophic dermatofibromas have been observed worldwide; indeed, publications describing individuals with this lesion have originated from Argentina [15], Austria [9], Brazil [26], Canada [16], Cuba [14], France [12, 13], Germany [7], India [28], Italy [23], Japan [17, 18], Korea [20, 25], Mexico [11, 21], Portugal [27], Spain [8, 19], Turkey [22] and the United States [10, 24, 29, 30]. Most of the articles (14 of 24, 58%) on atrophic dermatofibromas describe one individual [10, 12, 13, 17–22, 24, 26, 28–30]; including our paper, two or three patients are reported in six manuscripts (25%) [8, 15, 16, 25, 27].…”

“…The duration of time that the atrophic dermatofibroma was noted prior to establishing the diagnosis was described in 11 women (Table 5) [7–18, 21–23, 25–29] and 5 men (Table 6) [7–9, 11–14, 19, 20, 22–24, 27, 30]; also, the average duration of the lesion was 5.8 years in an additional 11 patients [7]. Therefore, the dermatofibroma was present from 3 to more than 40 years (median, 8 years) in the women and from 1 to 20 years (median, 3 years) in the men before the diagnosis was confirmed.…”

“…Her 1.5-cm tumor presented as a non-tender erythematous atrophic plaque. In addition to a pigment network and scar-like white patches, dermoscopy revealed arborizing vessels arising from a bluish homogenous area resembling a flame pattern [21].…”

“…A combined dermatofibroma is a dermatofibroma that demonstrates the coexistence of two variant patterns in a single lesion [6]. Three patients (two men [19, 20] and one woman [21]) had combined (atrophic and aneurysmal) dermatofibromas. The tumors were on the back [20], upper trunk [19] and upper arm [21].…”

“…Three patients (two men [19, 20] and one woman [21]) had combined (atrophic and aneurysmal) dermatofibromas. The tumors were on the back [20], upper trunk [19] and upper arm [21]. The woman’s lesion was asymptomatic [21]; however, both of the men’s tumor was painful [19, 20].…”