Beyond classic dermoscopic patterns of dermatofibromas: a prospective research study

Abstract

BackgroundThe usual stereotypical dermoscopic pattern associated with dermatofibromas is a pigment network and central white patch. However, this pattern may be difficult to diagnose in some variant cases. We aimed to describe dermoscopic patterns of dermatofibroma according to its histopathological subtypes, with special emphasis on new and rare dermoscopic features.MethodsThis prospective study, which was conducted between September 2015 and May 2016 in the Department of Dermatology, University Hospital Hassan II, Fez, Morocco, included 100 cases of dermatofibroma confirmed on clinical and histological grounds. Each lesion was scored for classic, previously reported, or new dermoscopic features.ResultsAll our Moroccan patients had a dark skin phototype (Fitzpatrick scale types IV and V). A total of 14 morphological dermoscopic structures were distinguished, and 17 dermoscopic patterns were observed, with the most common pattern being the central white patch and peripheral pigment network (21%). New patterns observed in our study were a white ring around an ulceration (6%), a pigment network with a pigmented ring around follicular openings (2%), and a discreet peripheral network and starlike white patch (3%). A patchy network with white patches was significantly noted in atrophic dermatofibroma (p = 0.01); vascularization was described in both aneurysmal and hemosiderotic dermatofibromas (p = 0.002); and a white ring around an ulceration was noted in aneurysmal dermatofibroma (p < 0.001).ConclusionsWe provide a description of dermoscopic patterns of dermatofibroma according to its histological subtypes in a dark skin phototype, along with a new report of a white ring around an ulceration as a significant pattern in aneurysmal dermatofibroma.

Hemosiderotic Dermatofibroma: A Rare and Atypical Variant Capable of Clinically Resembling Melanoma

“…Atypical variants of DF, such as HDF (once progressed to aneurysmal DF [ADF]), are more likely to have high proliferative activity and recurring metastasis with metastasis noted as early as three months after first diagnosis [7,8]. In contrast, the median time-to-metastasis for localized melanoma is 28 months [9]. The hemosiderin deposits and dermal blood-filled cavities, characteristic of HDF, histopathologically resemble melanoma or vascular tumors [1,10].…”

Atrophic Dermatofibroma: A Comprehensive Literature Review

“…They typically occur as solitary lesions; however, multiple dermatofibromas can be associated with various conditions [5]. Several clinical and pathological variants of a dermatofibroma have been described (Table 1) [2–4, 6–11]. An atrophic dermatofibroma is a rare subtype of dermatofibroma [7–30].…”

“…Significant contributions to the atrophic dermatofibroma literature are summarized in Table 2 [7–9, 11–24]. In this article, we summarize the world literature on this subject.…”

“…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].…”

A nodule on the breast: what’s your diagnosis?

“…The delicate light brown pigment network surrounding the tumor is related to the hyperpigmented rete ridges usually present at the edge of dermatofibromas. Kelati et al [8], reported a new dermoscopic description of this polymorphous tumor as a white ring around an ulceration associated with linear irregular vessels and dotted vessels. These findings were related to the histological presence of large and superficial bloodfilled spaces that may cause epidermal removal and ulceration surrounded by fibrosis.…”