Hemosiderotic dermatofibroma: Unique clinical presentation and dermoscopic findings of a rare dermatofibroma variant

Abstract

Hemosiderotic dermatofibromas (HDFs) are a rare variant of the relatively common dermatofibroma (DF). HDFs can clinically mimic melanoma as well as other melanocytic lesions and are diagnosed with histopathological examination. Histopathologic diagnosis is not straightforward as there are many DF variants and the features of several variants can often be found in one lesion. These lesions may represent a stage in development from common DF to aneurysmal dermatofibroma (ADF). This possible progression is important to recognize, as ADFs tend to exhibit increased tendency for local recurrence and can also be confused with malignant lesions. We present a case of a 65-year-old presenting with a rare HDF having unique clinical and dermatoscopic findings. Our case underscores the importance of recognizing this rare entity and stresses the importance of remaining mindful of the possible progression to ADF, an entity with increased propensity for recurrence.

Hemosiderotic dermatofibroma mimicking melanoma: A case report and review of the literature

“…Majority of these cases raise concern for melanoma following initial dermatoscopic examination and excision was performed for a definite diagnosis. 11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] The area rich in poorly formed vessel-like structures can make the lesion look like a vascular tumor such as Kaposi's sarcoma both microscopically and clinically. 28 Given the patient having no clinical history of immunosuppressive diseases/conditions, the chance of Kaposi's sarcoma is likely to be very low.…”

“…In this scenario, a definite diagnosis could only be made by histopathological examination. There are three cases of HDF reported in the literature from the United States 13‐15 . Here, we report another case of HDF which was clinically suspicious for melanoma.…”