Dermatofibroma history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]
Overview
Although typical dermatofibromas cause little or no discomfort, itching and tenderness can occur.
Symptoms
Although typical dermatofibromas cause little or no discomfort, itching and tenderness can occur.
Overview
The majority of patients with [disease name] are asymptomatic.
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History and Symptoms
- The majority of patients with [disease name] are asymptomatic.
OR
- The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
- Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
Dermatofibromas typically arise slowly and most often occur as a solitary nodule on an extremity, particularly the lower leg, but any cutaneous site is possible. Dermatofibromas are usually asymptomatic, but itching and pain often are noted. They are the most common of all painful skin tumors. [1] Women who shave their legs may be bothered by the razor traumatizing the lesion in that region, causing pain, bleeding, erosive changes, and ulceration. Although cases of unusually rapid growth exist, most dermatofibromas remain static for decades or persist indefinitely. Patients may describe a hard mole or unusual scar and are often concerned about the possibility of skin cancer.
Several lesions may be present, but rarely are numerous (ie, ≥15) tumors found. This multiple eruptive variant occurs in less than 1% of patients, approximately 60% of whom have an underlying systemic condition, such as HIV infection or systemic lupus erythematosus. [30, 31, 32] However, dermatomyositis, [33] Graves disease, [34] Hashimoto thyroiditis, [35] myasthenia gravis, [35] Down syndrome, [36] leukemia, [37] myelodysplastic syndrome, [38] cutaneous T-cell lymphoma, [39] multiple myeloma, [39] atopic dermatitis, [40] Crohn disease, [41] and ulcerative colitis [42] have all been reported in association with the phenomenon. In addition, antiretroviral agents, [43] the biologic agent efalizumab, [44] antitumor necrosis factor-alpha agents, [45] and the tyrosine kinase inhibitor imatinib [46] have been linked to their appearance.
Both congenital [47] and acquired [48] cases of multiple clustered dermatofibromas have been reported.
Dermatofibromas are slow growing lesions which can affect any part of the body but have a predilection for the extremities. Clinically these lesions are a firm, non-tender cutaneous nodule, with or without overlying skin changes (such as tan-pink to reddish-brown discoloration, depending on the age of the lesion) with a smooth surface. Dermoscopic evaluation of these lesions will most commonly exhibit a central white patch with a peripheral pigmented network. Dermatofibromas are usually less than or equal to one centimeter in diameter. Patients are usually asymptomatic but will relate a history of local trauma at the site of the lesion such as vaccination or an insect bite in approximately one out of five cases. A thorough full body skin exam is important as these lesions may be subtle and are multiple in 10% of cases. The “dimple sign” is a characteristic finding where in lateral inward digital pressure of the skin produces a central dimpling over the lesion. [8] [9]
Dermatofibromas typically present as firm, often hyperpigmented, nodules 0.3 to 1 cm in diameter (picture 4A-B), but giant lesions larger than 3 cm in diameter have been described [11,12]. They occur most often in adults and are most commonly located on the lower extremities. Lesions are usually asymptomatic, but may be pruritic. On palpations, dermatofibromas are fixed to the subcutaneous tissues and characteristically dimple when pinched
Dermatofibromas usually develop slowly. These small, hard, raised skin growths:
Usually, appear on the lower legs, but may appear on the arms or trunk May be red, pink, purplish, gray or brown and may change color over time May be as small as a BB pellet but rarely grow larger than a fingernail Are often painless but may be tender, painful or itchy Usually, dimple inward when pinched
History
Patients with [disease name]] may have a positive history of:
- [History finding 1]
- [History finding 2]
- [History finding 3]
Common Symptoms
Common symptoms of [disease] include:
- [Symptom 1]
- [Symptom 2]
- [Symptom 3]
Less Common Symptoms
Less common symptoms of [disease name] include
- [Symptom 1]
- [Symptom 2]
- [Symptom 3]
References