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Dermatofibroma

Dermatofibroma, also called fibrous histiocytoma, is a benign skin tumor that is common but usually causes concern when found.

Traditionally, the growths were attributed to the body’s reactive response to trauma, such as an insect bite. However, their exact etiology is not clear.

They appear as clonal proliferative neoplasms from dermal dendritic histiocyte cells.

They are more common in women than men by a ratio of 4 to 1 and can occur at any age, most often in young adulthood.

What are the symptoms?

Fibrous histiocytomas are usually solitary nodules that develop on the extremities, most commonly on the legs.

The main part of the tumor is inside the skin, and only a small part of it is visible on the surface in the form of a hemisphere.

The appearance of the neoplasm depends on its structure, insofar as there are more dermal fibers or connective tissue in it. Dermatofibromas have a rounded shape and a thick consistency.

When putting pressure on them, they move freely and are 0.5-1.0 cm in diameter, sometimes patients say that they feel like a small lens under the surface of the skin.

The skin surface is usually smooth and sometimes scaly. The color of the skin varies from her characteristic to that of pink/red cream or from white to brown.

Depending on what kind of tissue predominates, the neoplasm may have a segmental structure with a bent, drooping surface and may not be localized subcutaneously, but only attached to the skin surface.

Soft tumors can reach the size of a child’s head and are usually located on the face.

Hard fibrous histiocytomas have a very dense surface and consist almost entirely of connective tissue, and tumors of this type can spontaneously disappear.

Lesions can appear anywhere on the skin and affected individuals may have several, up to 15.

More are usually formed when the immune system is damaged, for example autoimmune disease, systemic lupus erythematosus, HIV, leukemia.

The nodule is usually asymptomatic, but may cause itching or a feeling of skin tightness at the site of its localization. After the initial growth, they usually stop growing and remain a static size.

Treatment for dermatofibroma

• Take it easy no treatment is usually needed;

• Removal is necessary if they are in a location where they are cosmetically unacceptable or there is symptomatic or diagnostic uncertainty regarding the neoplasm.

It should be taken into account that frequency of local recurrences is quite high, in about ¼ of the patients.

• Removal by elliptical excision or puncture biopsy usually provides the most satisfactory results.

Laser removal is just as effective, as no scars remain, blood loss is minimal, and the patient recovers his ability to work after a few days.

With so-called shave excision, consisting in removal of the lesion only to the surface of the skin, or cryotherapy, there is a risk of incomplete removal of the node and recurrence.

• In about 2% of fibrous histiocytoma excisions, unexpected or rare malignancies are found.

So even when excision of the lesion is only for cosmetic or symptomatic reasons, it is necessary to send some of the removed tissue for histology.

In some patients, after the normalization of their liver function, neoplasms initially decrease in size and subsequently disappear.

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