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Kelly BG, Joyce JC, Liegl MA, Pan A, Wanat KA, Lalor L. Pediatric dermatofibromas: Truncal predominance in younger children. Pediatr Dermatol 2024; 41:465-467. [PMID: 38409816 DOI: 10.1111/pde.15568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 02/02/2024] [Indexed: 02/28/2024]
Abstract
Pediatric dermatofibromas are considered rare in young children and have not been well characterized, often misdiagnosed clinically. We performed a retrospective case series of children younger than 18 years with histopathologically diagnosed dermatofibromas at our institutions and evaluated age at onset and diagnosis, sex, lesion location, and size, associated symptoms, change over time, and pre-biopsy diagnosis. Overall, dermatofibromas were most common on the back and chest (20/53; 38%), followed by the legs (15/53; 28%) and arms (12/53; 23%) with the most common pre-biopsy diagnosis of "cyst" (23/53; 43%), followed by dermatofibroma (16/53; 30%), and pilomatricoma (12/53; 23%). Our study reinforces previous findings of truncal predominance of pediatric dermatofibromas, different from adults.
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Affiliation(s)
- Brenna G Kelly
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Joel C Joyce
- Division of Dermatology, NorthShore University HealthSystem, Skokie, Illinois, USA
| | - Melodee A Liegl
- Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Amy Pan
- Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Karolyn A Wanat
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Leah Lalor
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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2
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Challenging Patterns of Atypical Dermatofibromas and Promising Diagnostic Tools for Differential Diagnosis of Malignant Lesions. Diagnostics (Basel) 2023; 13:diagnostics13040671. [PMID: 36832159 PMCID: PMC9955442 DOI: 10.3390/diagnostics13040671] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
Dermatofibroma (DF) or fibrous histiocytoma is one of the most frequent benign cutaneous soft-tissue lesions, characterized by a post-inflammatory tissue reaction associated with fibrosis of the dermis. Clinically DFs have a polymorphous clinical aspect from the solitary, firm, single nodules to multiple papules with a relatively smooth surface. However, multiple atypical clinicopathological variants of DFs have been reported and, therefore, clinical recognition may become challenging, leading to a more burdensome identification and sometimes to misdiagnosis. Dermoscopy is considered an important tool in DFs diagnosis, as it improves diagnostic accuracy for clinically amelanotic nodules. Although typical dermoscopic patterns are most frequently seen in clinical practice, there have also been some atypical variants described, mimicking some underlying recurrent and sometimes harmful skin afflictions. Usually, no treatment is required, although an appropriate work-up may be necessary in specific cases, such as in the presence of atypical variants or a history of recent changes. This narrative review's aim is to summarize current evidence regarding clinical presentation, positive and differential diagnosis of atypical dermatofibromas and also to raise awareness about the importance of specific characteristics of atypical variants to better differentiate them from malignant conditions.
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3
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Zaballos P, Álvarez-Salafranca M, Llambrich À, Malvehy J, Taberner R, Medina C, Argenziano G, Thomas L, Pizarro Á, Del Pozo LJ, Avilés JA, Martin JM, Karaarslan I, Guionnet N, Bañuls J. Dermoscopy of haemosiderotic/aneurysmal dermatofibroma: A morphological study of 110 cases. J Eur Acad Dermatol Venereol 2023; 37:317-327. [PMID: 36251407 DOI: 10.1111/jdv.18664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/21/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Haemosiderotic and aneurysmal dermatofibromas are uncommon and frequently misdiagnosed lesions, which can be considered as different histopathological stages of the same tumour. A dermoscopic diagnosis testing accuracy has not been performed for these tumours to date. OBJECTIVES To determine the diagnostic significance of dermoscopic structures and patterns associated with haemosiderotic/ aneurysmal dermatofibromas in a large series. METHODS Dermoscopic images of histopathologically proven cases of 110 haemosiderotic/ aneurysmal dermatofibromas and 501 other tumours were collected. The frequency, sensitivity, specificity, positive predictive value and negative predictive value of the dermoscopic structures and patterns associated with these lesions were calculated. RESULTS Haemosiderotic/ aneurysmal dermatofibromas are mostly symmetric lesions (86.5%), and a prominent homogeneous area was present in 100% of them. The presence of vascular structures was very common (86.4%), and dotted vessels were predominant (58.2%). Shiny white structures were seen in 85.5% of lesions, while a peripheral delicate pigment network was present in 69.1%. The most significant pattern was the one composed of a prominent homogeneous area and peripheral delicate pigment network, which showed a specificity of 100% with a relatively good sensitivity (69.1%). All the patterns containing a peripheral delicate pigment network showed very good specificities, positive predictive values and negative predictive values. Those patterns without a peripheral delicate pigment network showed the highest sensitivities, but they showed a significant overlap with other tumours, mainly with melanoma. CONCLUSIONS Dermoscopy is helpful in improving the diagnostic accuracy of haemosiderotic/ aneurysmal dermatofibromas. However, there is a considerable dermoscopic overlap between these tumours and melanoma, specifically when the peripheral delicate pigment network is absent.
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Affiliation(s)
- Pedro Zaballos
- Dermatology Department, Hospital Sant Pau i Santa Tecla, Tarragona, Spain
| | | | - Àlex Llambrich
- Dermatology Department, Hospital Universitari Son Llatzer, Palma de Mallorca, Spain
| | - Josep Malvehy
- Dermatology Department, Hospital Clínic, Barcelona, Spain
| | - Rosa Taberner
- Dermatology Department, Hospital Universitari Son Llatzer, Palma de Mallorca, Spain
| | - Carolina Medina
- Dermatology Department, Hospital Universitario de Gran Canaria "Doctor Negrín", Gran Canaria, Spain
| | | | - Luc Thomas
- Department of Dermatology, Centre Hospitalier Lyon Sud, Lyon, France.,Lyon 1 University, Lyon, France.,Lyons Cancer Research Center UMR INSERM U1052 - CNRS5286 - UCBL1, Lyon, France
| | - Ángel Pizarro
- Dermatology Department, Clínica Dermatológica Internacional, Madrid, Spain
| | - Luis Javier Del Pozo
- Dermatology Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Jose Antonio Avilés
- Dermatology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Jose María Martin
- Dermatology Department, Hospital Clínico Universitario, Valencia, Spain
| | - Isil Karaarslan
- Dermatology Department, Medical University of Ege, Izmir, Turkey
| | - Neus Guionnet
- Pathology Department, Hospital de Sant Pau I Santa Tecla, Tarragona, Spain
| | - José Bañuls
- Dermatology Department, Hospital General Universitario de Alicante, ISABIAL, Alicante, Spain
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Giddens T, Seiverling E, Marghoob A, Usatine R. Absence of central white patch in dermatofibromas presenting in darker skin. JAAD Case Rep 2022; 21:63-65. [PMID: 35198701 PMCID: PMC8841499 DOI: 10.1016/j.jdcr.2021.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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5
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Kubelis-López DE, Villarreal-Martínez A, Fernández LT, Velázquez-Rodríguez C, Malvehy J, Ocampo-Candiani J, Garza-Rodríguez V. Dermoscopic patterns and features of dermatofibroma in darker skin phototypes. Int J Dermatol 2021; 61:e282-e286. [PMID: 34817858 DOI: 10.1111/ijd.15979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/13/2021] [Accepted: 10/28/2021] [Indexed: 11/29/2022]
Affiliation(s)
- David E Kubelis-López
- Dermatology Department, Universidad Autónoma de Nuevo León, Hospital Universitario, Monterrey, Nuevo León, México
| | | | - Lucía T Fernández
- Dermatology Department, Universidad Autónoma de Nuevo León, Hospital Universitario, Monterrey, Nuevo León, México
| | | | - Josep Malvehy
- Universidad de Barcelona, Hospital Clinic de Barcelona, IDIBAPS, CIBERER, Barcelona, España
| | - Jorge Ocampo-Candiani
- Dermatology Department, Universidad Autónoma de Nuevo León, Hospital Universitario, Monterrey, Nuevo León, México
| | - Veronica Garza-Rodríguez
- Dermatology Department, Universidad Autónoma de Nuevo León, Hospital Universitario, Monterrey, Nuevo León, México
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Aytekin S, Kaynak E, Ayhan E. Dermoscopy of dermatofibromas: A new perspective. Int J Clin Pract 2021; 75:e14547. [PMID: 34137132 DOI: 10.1111/ijcp.14547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/28/2021] [Accepted: 06/16/2021] [Indexed: 11/28/2022] Open
Abstract
AIM In dermoscopic studies on dermatofibromas, some publications divide the appearance of lesions into standardised patterns, and some publications classify the clinical appearance of the lesions by comparing them with existing dermatological lesions. This study aims to re-evaluate the dermoscopic findings and patterns of dermatofibromas from a different perspective. MATERIALS AND METHODS In this study, 142 lesions of 72 patients were evaluated dermoscopically and their patterns were schematised. RESULTS In our study, a total of 15 patterns consisting of main and sub-patterns were created. The most common patterns we detected were pattern 1 (1a: 13.4%, 1b: 8.5%), pattern 8 (8a: 10.6%, 8b: 4.2%) and pattern 2 (2a: 9.2%, 2b: 4.2%), respectively. CONCLUSION Patterns of DFs were reclassified while preserving basic patterns. We think that the new sub-patterns and schematisation with this study can contribute to a better understanding of DFs.
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Affiliation(s)
- Sema Aytekin
- Department of Dermatology, University of Health Sciences Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | | | - Erhan Ayhan
- Department of Dermatology, University of Health Sciences Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
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Li C, Allen H, Loxas M, Sharma P. Hemosiderotic dermatofibroma mimicking melanoma: A case report and review of the literature. Clin Case Rep 2021; 9:1387-1392. [PMID: 33768851 PMCID: PMC7981605 DOI: 10.1002/ccr3.3780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/13/2020] [Indexed: 11/06/2022] Open
Abstract
Hemosiderotic dermatofibroma (HDF) often mimics melanoma clinically. A definite diagnosis relies on histopathological evaluation and immunohistochemistry. As it can progress to aneurysmal dermatofibroma (ADF), complete excision is recommended.
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Affiliation(s)
- Changzhao Li
- Department of PathologyCreighton University School of MedicineOmahaNEUSA
| | - Hunter Allen
- Creighton University School of MedicineOmahaNEUSA
| | | | - Poonam Sharma
- Department of PathologyCreighton University School of MedicineOmahaNEUSA
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8
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Ezenwa E, Stein JA, Krueger L. Dermoscopic features of neoplasms in skin of color: A review. Int J Womens Dermatol 2021; 7:145-151. [PMID: 33937480 PMCID: PMC8072485 DOI: 10.1016/j.ijwd.2020.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/11/2020] [Accepted: 11/19/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Dermoscopy is undoubtedly a useful tool to improve diagnostic accuracy and minimize the number of unnecessary biopsies. However, much of the literature on dermoscopy focuses on findings in lighter-skin phototypes, leaving potential gaps of knowledge regarding its use in skin of color (SoC). As the clinical applications of dermoscopy continue to increase, understanding dermoscopic patterns in SoC is imperative. OBJECTIVE This review discusses the literature on dermoscopic findings of neoplasms in SoC, highlighting unique and characteristic dermoscopic features. METHODS A literature review was performed using the PubMed database. Case reports, case series, case-control studies, and systematic reviews were included. RESULTS A total of 8326 studies were identified based on the selected search terms, and 41 were included in this review based on relevance. CONCLUSION There are specific dermoscopic characteristics in SoC for benign nevi, acral lentiginous melanoma, ethnic melanonychia, and dermatofibroma; however, there is a lack of published data about specific features of cutaneous melanoma, subungual melanoma, pigmented basal cell carcinoma, and pigmented squamous cell carcinoma in SoC. Because pigmented basal cell carcinoma, pigmented squamous cell carcinoma, ethnic melanonychia, and acral lentiginous melanoma are diagnosed at later stages in this population, it is important to understand their dermoscopic features. Further descriptive studies are needed to better characterize unique dermoscopic features in neoplasms in SoC.
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Affiliation(s)
- Ekene Ezenwa
- Department of Internal Medicine, University of Oklahoma, School of Community Medicine, Tulsa, OK, United States
| | - Jennifer A. Stein
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, United States
| | - Loren Krueger
- Emory University School of Medicine, Department of dermatology, 1525 clifton Rd NE, Atlanta, GA 30322
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Puri N, Brar B, Azhagappan A. Atrophic dermatofibroma in a young female: A rare entity. J Cutan Aesthet Surg 2021; 14:446-448. [PMID: 35283608 PMCID: PMC8906261 DOI: 10.4103/jcas.jcas_100_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: Atrophic dermatofibroma is a rare variant of dermatofibroma which is many times underdiagnosed. Case Report: We report a case report of a 29-year-old female who came to the dermatology department with black-colored lesions on the lower leg for the past 7 years. Histopathological examination revealed a non-encapsulated dermal tumor involving upper to deep reticular dermis and extending to superficial subcutis. There was epidermal hyperplasia, and at the center of the lesion a slight epidermal atrophy was present. Discussion: It is a commonly underdiagnosed variant of dermatofibroma. Histopathologically, this disorder presents as a decrease in at least 50% of the thickness of the dermis relative to the adjacent dermis. The case is rare and hence reported.
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10
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Scarano A, Carinci F, Candotto V, Lorusso F. Eradication of Benign Skin Lesions of the Face by Voltaic Arc Dermabrasion (Atmospheric Plasma): Postoperative Pain Assessment by Thermal Infrared Imaging. Aesthetic Plast Surg 2020; 44:2277-2285. [PMID: 32767038 PMCID: PMC7683462 DOI: 10.1007/s00266-020-01891-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/19/2020] [Indexed: 11/04/2022]
Abstract
Objectives The face aging processes are associated with physiologic and biochemical alteration that produces wrinkles, skin pigmentation and benign growths. The aim of this study was to evaluate the clinical efficacy of voltaic arc dermabrasion with plasma to remove benign facial skin lesions. Study Design Voltaic arc dermabrasion plasma technique was used to remove the facial benign skin lesions. The study involved 45 patients (26 females;19 males) treated for benign facial skin lesions with voltaic arc dermabrasion also called plasma exeresis technique. The subjects age ranged between 43 and 65 years. The clinical observations and comparison of pretreatment and post-treatment photographs of the treated regions were performed by a joint examiner at each follow-up visit. Results During plasma irradiation, the average temperature of the skin was 290.3 ± 21.7 °C, while immediately after it was 90.6 ± 21.8 °C. Overall clinical improvement was 100% in six lesions with complete resolution of all lesions. Three patients observed a transient post-inflammatory pigmentation with a peak at 1 month after VAD treatment, gradually fading spontaneously over 2 to 3 months. Conclusions The voltaic arc dermabrasion technique (atmospheric plasma) should be considered for lesions, especially relatively superficial ones, and small lesions that are located on the face. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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11
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Sgouros D, Lallas A, Kittler H, Zarras A, Kyrgidis A, Papageorgiou C, Puig S, Scope A, Argenziano G, Zalaudek I, Pizzichetta MA, Marghoob A, Liopyris K, Malvehy J, Oikonomou C, Flórez A, Braun R, Cabo H, Nazzaro G, Lanssens S, Menzies S, Paoli J, Kaminska-Winciorek G, Longo C, Katoulis A, Apalla Z, Ioannides D, Thomas L, Tromme I, Ogata D, Desinioti C, Geller A, Stratigos A. Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non-melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2020; 34:2541-2547. [PMID: 32654237 DOI: 10.1111/jdv.16815] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/02/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Thin nodular melanoma (NM) often lacks conspicuous melanoma-specific dermatoscopic criteria and escapes clinical detection until it progresses to a thicker and more advanced tumour. OBJECTIVE To investigate the dermatoscopic morphology of thin (≤2 mm Breslow thickness) vs. thick (>2 mm) NM and to identify dermatoscopic predictors of its differential diagnosis from other nodular tumours. METHODS Retrospective, morphological case-control study, conducted on behalf of the International Dermoscopy Society. Dermatoscopic images of NM and other nodular tumours from 19 skin cancer centres worldwide were collected and analysed. RESULTS Overall, 254 tumours were collected (69 NM of Breslow thickness ≤2 mm, 96 NM >2 mm and 89 non-melanoma nodular lesions). Light brown coloration (50.7%) and irregular brown dots/globules (42.0%) were most frequently observed in ≤2 mm NMs. Multivariate analysis revealed that dotted vessels (3.4-fold), white shiny streaks (2.9-fold) and irregular blue structureless area (2.4-fold) were predictors for thinner NM compared to non-melanoma nodular tumours. Overall, irregular blue structureless area (3.4-fold), dotted vessels (4.6-fold) and serpentine vessels (1.9-fold) were predictors of all NM compared to non-melanoma nodular lesions. LIMITATIONS Absence of a centralized, consensus pathology review and cases selected form tertiary centres maybe not reflecting the broader community. CONCLUSIONS Our study sheds light into the dermatoscopic morphology of thin NM in comparison to thicker NM and could provide useful clues for its differential diagnosis from other non-melanoma nodular tumours.
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Affiliation(s)
- D Sgouros
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Lallas
- 1st Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Zarras
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Kyrgidis
- Department of Clinical Pharmacology, Aristotle University, Thessaloniki, Greece
| | - C Papageorgiou
- 1st Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salut de Carlos III, Barcelona, Spain
| | - A Scope
- Medical Screening Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Argenziano
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - M A Pizzichetta
- Department of Dermatology, University of Trieste, Trieste, Italy.,Division of Medical Oncology - Preventive Oncology, National Cancer Institute, Aviano, Italy
| | - A Marghoob
- Memorial Sloan Kettering Cancer Center, Hauppauge, NY, USA
| | - K Liopyris
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.,Memorial Sloan Kettering Cancer Center, Hauppauge, NY, USA
| | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona IDIBAPS, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salut de Carlos III, Barcelona, Spain
| | - C Oikonomou
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Flórez
- Department of Dermatology, Pontevedra University Hospital, Pontevedra, Spain
| | - R Braun
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - H Cabo
- Dermatology Institute of Medical Reserch, University of Buenos Aires, Buenos Aires, Argentina
| | - G Nazzaro
- Dermatology Unit, Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - S Lanssens
- Private practice Dermatology Maldegem, Maldegem, Belgium
| | - S Menzies
- Discipline of Dermatology, Sydney Medical School, The University of Sydney and Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - J Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - G Kaminska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Skłodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice Branch, Gliwice, Poland
| | - C Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A Katoulis
- 2nd Department of Dermatology-Venereology, "Attikon" General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Z Apalla
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - D Ioannides
- 1st Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - L Thomas
- Department of Dermatology, Lyon University, Lyon, France
| | - I Tromme
- Department of Dermatology, King Albert II Institute, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - D Ogata
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - C Desinioti
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - A Geller
- Department of Social and Behavioral Sciences, Harvard TH School of Public Health, Boston, MA, USA
| | - A Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
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12
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Pogorzelska-Antkowiak A, Wcisło-Dziadecka D, Brzezińska-Wcisło L, Pawlicki K, Antkowiak R, Corneli P. Features of dermatofibroma in reflectance confocal microscopy. Int J Dermatol 2020; 59:951-954. [PMID: 32496610 DOI: 10.1111/ijd.14972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/21/2020] [Accepted: 05/04/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Dermatofibroma (DF) is a common benign skin lesion in a majority of cases located on the legs or upper limbs. The etiology of DF is still unclear. OBJECTIVES Reflectance confocal microscopy features of DF were described. METHODS Forty patients with DF diagnosis confirmed by dermoscopy were examined using reflectance confocal microscopy VivaScope 1500 from March 2018 to April 2019. RESULTS DF was more common in females (80%) than males (20%). Thirty-six lesions (90%) were located on the limbs while four (10%) were on the trunk. Dermoscopically, 18 lesions (45%) revealed typical features: central white area with a brown network in the periphery. Twenty-two DFs (55%) were found with a central white patch and globular-like structures, surrounded by a thin brown network. In reflectance confocal microscopy, all revealed a typical honeycombed pattern, although in some cases (30%), streaming was observed. In two lesions (5%) in epidermis, few dendritic cells were observed, and one DF revealed roundish pagetoid cells (2.5%). The dermoepidermal junction (DEJ) in all lesions was abounded in dilated vessels. The most common observable feature of DF was bright "rings" composed of monomorphic, regular cells surrounding dark dermal papillae. In five lesions (12.5%), rings were "double" because of exceptionally pigmented DF. CONCLUSION Reflectance confocal microscopy enables us to describe microscopic features of DF. There are four confocal microscopic features observable in each DF: in the epidermis, normal honeycombed pattern, sometimes with local streaming, in DEJ, edged papillae, bright rings, and dilated vessels.
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Gaufin M, Michaelis T, Duffy K. Cellular Dermatofibroma: Clinicopathologic Review of 218 Cases of Cellular Dermatofibroma to Determine the Clinical Recurrence Rate. Dermatol Surg 2020; 45:1359-1364. [PMID: 30741794 DOI: 10.1097/dss.0000000000001833] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cellular dermatofibromas, a variant of dermatofibroma, are reported to recur at rates of 26% to 50%. OBJECTIVE To determine whether there are distinct clinical or histological differences between cellular dermatofibromas that recur versus those that do not. To determine recurrence rates in a real-world clinical setting. MATERIALS AND METHODS A retrospective analysis of the medical records and skin biopsies of cellular dermatofibroma in the University of Utah Health system between December 2011 and 2016. Clinical and dermatopathological features were evaluated to find distinct differences between the cellular dermatofibromas that recurred compared with those that did not. RESULTS There were no significant differences in histology between the primary lesions in recurrent and nonrecurrent cases. One factor that seemed to be associated with a greater likelihood of recurrence was an initial lesion size greater than 1 cm. The authors' data suggest that if the margins are involved on initial biopsy, there is a 10% chance of recurrence. This percentage is far less than the 26% to 50% reported in the past literature. CONCLUSION If a patient presents with a cellular dermatofibroma larger than 1 cm and positive margins at initial biopsy, a careful discussion should be had between the provider and patient about the low risk of local recurrence.
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Affiliation(s)
- Meredith Gaufin
- School of Medicine, University of Utah, Salt Lake City, Utah
| | | | - Keith Duffy
- Department of Dermatology, University of Utah, Salt Lake City, Utah
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14
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Lagziel T, Sylvester S, Hultman CS, Asif M. Hemosiderotic Dermatofibroma: A Rare and Atypical Variant Capable of Clinically Resembling Melanoma. Cureus 2020; 12:e6736. [PMID: 32133258 PMCID: PMC7034752 DOI: 10.7759/cureus.6736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A dermatofibroma (DF) is a common, benign tumor composed of fibroblastic and histiocytic cells. DF presents clinically with several different reported variants. One rare variant is hemosiderotic DF (HDF), which is made up of small blood vessels and hemosiderin deposits. HDF can be indistinguishable, clinically, from melanoma, making the use of other pathological tools crucial in the diagnosis. We report the case of a 25-year-old male medical student from the Caribbean who presented to our clinic with a single asymptomatic pigmented cystic lesion on his left posterior calf. The cystic lesion was excised surgically. Histopathology examination of the excised mass revealed a moderately cellular, poorly demarcated, dermal, fibrohistiocytic proliferation. Pathology consultation confirmed a diagnosis of HDF.
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Affiliation(s)
- Tomer Lagziel
- Plastic Surgery, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Scott Sylvester
- Plastic Surgery, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Charles S Hultman
- Plastic Surgery, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Mohammed Asif
- Plastic Surgery, The Johns Hopkins University School of Medicine, Baltimore, USA
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15
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Cohen PR, Erickson CP, Calame A. Atrophic Dermatofibroma: A Comprehensive Literature Review. Dermatol Ther (Heidelb) 2019; 9:449-468. [PMID: 31338755 PMCID: PMC6704206 DOI: 10.1007/s13555-019-0309-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION An atrophic dermatofibroma is a benign fibrohistiocytic neoplasm. It typically presents as an asymptomatic patch with a depressed central area. METHODS The PubMed database was used to search the following words: atrophic, dermatofibroma, elastic and fibers. The relevant papers and their references generated by the search were reviewed. Images of the clinical and pathological features of two patients with an atrophic dermatofibroma are presented. In addition, a comprehensive review of the characteristics of this unique dermatofibroma is provided. RESULTS An atrophic dermatofibroma has been reported in 102 patients: 53 women, 11 men and 38 individuals whose gender was not provided. It typically appeared as an asymptomatic solitary patch with a central umbilication-most commonly on the shoulder or lower extremity or back-of women aged 48 years or older. Dermoscopy typically showed white scar-like patches; a patchy pigment network was also noted in some lesions. The pathology of an atrophic dermatofibroma has the same features that can be observed in a common fibrous dermatofibroma; there is acanthosis, basal layer hyperpigmentation, and induction of basal cell carcinoma-like features, hair follicle formation or sebaceous hyperplasia in the epidermis and a proliferation of spindle-shaped fibroblasts in the dermis. However, atrophic dermatofibromas also demonstrate depression of the central surface and thinning of the dermis; in many cases, the dermal atrophy is at least 50%. Elastic fibers are either decreased or absent. Similar to non-atrophic dermatofibromas, the immunoperoxidase profile of atrophic dermatofibromas is factor XIIIa-positive and cluster of differentiation 34 (CD34)-negative. The pathogenesis of atrophic dermatofibromas remains to be established. CONCLUSION An atrophic dermatofibroma is an uncommon benign variant of a dermatofibroma. The diagnosis can be suspected based on clinical features and dermatoscopic findings. A biopsy of the lesion will confirm the diagnosis. Periodic evaluation of the lesion site is a reasonable approach to the management of the residual tumor.
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Affiliation(s)
- Philip R Cohen
- San Diego Family Dermatology, National City, CA, USA.
- Touro University California College of Osteopathic Medicine, Vallejo, CA, USA.
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16
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Genc Y, Akay BN, Okcu Heper A, Rosendahl C, Erdem C. Dermatopathological characteristics of dermatofibromas from dermatoscopic clues. Int J Dermatol 2019; 59:66-75. [DOI: 10.1111/ijd.14559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/11/2019] [Accepted: 05/31/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Yeser Genc
- Department of Dermatology Ankara University School of Medicine Ankara Turkey
| | - Bengu Nisa Akay
- Department of Dermatology Ankara University School of Medicine Ankara Turkey
| | - Aylin Okcu Heper
- Department of Pathology Ankara University School of Medicine Ankara Turkey
| | | | - Cengizhan Erdem
- Department of Dermatology Ankara University School of Medicine Ankara Turkey
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17
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Biondo G, Sola S, Brunasso AMG, Massone C. Melanoma and Clark naevus in collision tumours with a dermatofibroma. Australas J Dermatol 2019; 60:246-248. [DOI: 10.1111/ajd.13024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Giovanni Biondo
- Dermatology Unit Galliera Hospital Genoa Italy
- Dermatology and Sexual Trasmitted Disease Unit “P. Giaccone” Hospital University of Palermo Palermo Italy
| | - Simona Sola
- Surgical Pathology Galliera Hospital Genoa Italy
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18
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Mazzella C, Villani A, Scalvenzi M, Fabbrocini G, Cantelli M, Costa C. How reflectance confocal microscopy can help diagnose an enigmatic variant of dermatofibroma. Dermatol Ther 2019; 32:e12857. [PMID: 30748080 DOI: 10.1111/dth.12857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/23/2019] [Accepted: 02/10/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Caterina Mazzella
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Alessia Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Massimiliano Scalvenzi
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Gabriella Fabbrocini
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Mariateresa Cantelli
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Claudia Costa
- Dermatology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
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19
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Lozano-Masdemont B, Polimón-Olabarrieta I, Pérez-Tato B, Diego-Hernández C. A white-bluish plaque with rapid growth after palpation. Dermatol Pract Concept 2018; 8:337-339. [PMID: 30479869 PMCID: PMC6246067 DOI: 10.5826/dpc.0804a19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/03/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
| | | | - Berta Pérez-Tato
- Department of Dermatology, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
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20
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Majerson D, Majluf P, Abarzúa-Araya Á, González-Bombadiére S. Asymptomatic heterogeneously black-pigmented plaque in a 58-year-old man: an unusual presentation of a melanoma mimicker. Dermatol Pract Concept 2018; 8:224-226. [PMID: 30116668 PMCID: PMC6092082 DOI: 10.5826/dpc.0803a14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 12/03/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Daniela Majerson
- Dermatology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paula Majluf
- Dermatology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Álvaro Abarzúa-Araya
- Dermatology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
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21
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Acar EM, Tad M, Kilitci A, Kemeriz F. Hemosiderotic dermatofibroma mimicking melanoma in a 12-year-old boy: a case report. Clin Case Rep 2018; 6:1006-1009. [PMID: 29881552 PMCID: PMC5986033 DOI: 10.1002/ccr3.1508] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/07/2018] [Accepted: 03/08/2018] [Indexed: 12/26/2022] Open
Abstract
We report a case of hemosiderotic dermatofibroma presenting as a brown-black-colored nodule with peripheral extensions, which mimics melanoma. Histopathology showed completely benign features with no atypia or mitosis. Nodular extensions of childhood dermatofibromas may be related to the growth of the child not necessarily pointing to a malignant process.
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Affiliation(s)
- Emine Müge Acar
- Department of DermatologyKırşehir Ahi Evran University Training and Research HospitalKırşehir40200Turkey
| | - Murat Tad
- Department of PathologyKırşehir Ahi Evran University Training and Research HospitalKırşehir40200Turkey
| | - Asuman Kilitci
- Department of PathologyKırşehir Ahi Evran University Training and Research HospitalKırşehir40200Turkey
| | - Funda Kemeriz
- Department of DermatologyAksaray University Training and Research HospitalAksaray68200Turkey
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22
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Hughes A, Tull TJ, Semkova K, Calonje E, Stefanato CM. An enlarging nodule on the shin. Clin Exp Dermatol 2018; 43:627-629. [PMID: 29508412 DOI: 10.1111/ced.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A Hughes
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - T J Tull
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - K Semkova
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - E Calonje
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - C M Stefanato
- Department of Dermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK
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23
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Behera B, Vinupriya S, Kumari R, Thappa DM, Gochhait D, Srinivas B, Toi P. Dermoscopic features of pilar leiomyomas. Br J Dermatol 2018; 179:202-204. [PMID: 29368390 DOI: 10.1111/bjd.16378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- B Behera
- Dermatology, Venereology and Leprology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
| | - S Vinupriya
- Dermatology, Venereology and Leprology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
| | - R Kumari
- Dermatology, Venereology and Leprology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
| | - D M Thappa
- Dermatology, Venereology and Leprology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
| | - D Gochhait
- Pathology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
| | - B Srinivas
- Pathology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
| | - P Toi
- Pathology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
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24
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Kelati A, Aqil N, Baybay H, Gallouj S, Mernissi FZ. Beyond classic dermoscopic patterns of dermatofibromas: a prospective research study. J Med Case Rep 2017; 11:266. [PMID: 28927449 PMCID: PMC5605998 DOI: 10.1186/s13256-017-1429-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 08/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The 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. METHODS This 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. RESULTS All 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). CONCLUSIONS We 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.
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Affiliation(s)
- Awatef Kelati
- Department of Dermatology, University Hospital Hassan II, Fez, Morocco.
| | - Nima Aqil
- Department of Dermatology, University Hospital Hassan II, Fez, Morocco
| | - Hanane Baybay
- Department of Dermatology, University Hospital Hassan II, Fez, Morocco
| | - Salim Gallouj
- Department of Dermatology, University Hospital Hassan II, Fez, Morocco
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25
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Blum A, Siggs G, Marghoob AA, Kreusch J, Cabo H, Campos-do-Carmo G, Shiraishi AFC, Kienitz A, Maldonado-Seral C, Maltagliati-Holzner P, Mijuskovic ZP, Yoshimura AM, Moscarella E, Rabinovitz HS, Rodriguez-Garcia C, Saa SR, Rubegni P, Savoia F, Simionescu O, Diego PZ, Hofmann-Wellenhof R. Collision skin lesions-results of a multicenter study of the International Dermoscopy Society (IDS). Dermatol Pract Concept 2017; 7:51-62. [PMID: 29230351 PMCID: PMC5720595 DOI: 10.5826/dpc.0704a12] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 08/20/2017] [Indexed: 11/25/2022] Open
Abstract
Background Collision lesions as two independent and unrelated skin tumors often manifest an atypical morphology. Objective To determine the combinations of collision skin lesions (CSLs). Methods Twenty-one pigmented lesion clinics in nine countries included 77 histopathologically proven CSLs in this retrospective observational study. Results Seventy-seven CSLs from 75 patients (median age 59.8 years) were analyzed; 24.7% of CSLs were located on the head and neck area, 5.2% on the upper extremities, 48.1% on the trunk, and 11.7% on the lower extremities; 40.3% revealed a melanocytic component (median age 54.7 years), followed by 45.5% with a basal cell carcinoma (BCC) (median age 62.4 years) and 11.7% with a seborrheic keratosis (median age 64.7 years). CSLs with a BCC component were more often found on the head and neck area compared to tumors with a melanocytic component (34.3% versus 16.1%). Lesions with a melanocytic component were more often detected on the trunk compared to lesions with a BCC (64.5% versus 37.1%). Patients with CSLs with epidermal-epidermal cell combination were older than patients with epidermal-dermal cell combination (63 versus 55.2 years), were more often male than female (63% versus 43.3%), more often had the lesion on the head and neck area (32.6% versus 13.3%), and less often on the upper (2.2 % versus 10%) or lower extremities (8.7% versus 16.6%). Conclusions CSLs consist of a heterogeneous group of lesions of varying cell types. They are associated with advancing age and cumulative UV-exposure. CSLs manifest a complex morphology making it challenging to diagnose correctly.
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Affiliation(s)
- Andreas Blum
- Public, Private and Teaching Practice of Dermatology, Konstanz, Germany
| | - Graeme Siggs
- SunDoctors Skin Cancer Clinic, Glenunga, Adelaide, Australia
| | - Ashfaq A Marghoob
- Department of Dermatology, Memorial Sloan Kettering Skin Cancer Center, New York, NY, USA
| | - Jürgen Kreusch
- Public and Private Practice of Dermatology, Lübeck, Germany
| | - Horacio Cabo
- Research Institut, University of Buenos Aires, Argentina
| | | | | | | | | | | | - Zeljko P Mijuskovic
- Department of Dermatology and Venereology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | | | - Elvira Moscarella
- Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | | | | | | | - Pietro Rubegni
- Department of Clinical Medicine and Immunological Science, Dermatology Section, University of Siena, Siena, Italy
| | | | - Olga Simionescu
- 1st Clinic of Dermatology, Carol Davila University of Medicine and Pharmacy, Colentina Hospital, Bucharest, Romania
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Abstract
Livedoid vasculopathy (atrophie blanche) is a form of thrombotic vasculopathy. It is characterized by small ulcers that become crusted, and heal after several months to produce white atrophic scars. The most commonly affected sites are the lower legs, in particular the dorsum of the feet and ankles. To date, the dermoscopic features of livedoid vasculopathy have not been clearly described in the literature. In this observational study, we sought to evaluate the dermoscopic patterns of livedoid vasculopathy and determine whether the dermoscopic features are associated with certain histopathological characteristics. We evaluated 9 patients with livedoid vasculopathy by dermoscopy. Skin biopsy specimens were stained with hematoxylin and eosin for histopathologic examination, and dermoscopic features were correlated with histopathological characteristics. In the majority of patients with livedoid vasculopathy, examination with dermoscopy revealed central crusted ulcers or ivory white areas associated with peripheral pigmentation in a reticular pattern. In addition, increased vascular structures including linear and glomerular vessels were found. On histopathological examination, the central ivory white areas correlated with dermal fibrosis, the reticular pigmentation corresponded to epidermal basal layer hyperpigmentation or melanin within melanophages in the dermal papillae, and the vascular structures correlated with dilatation and proliferation of capillaries in the upper dermis. In summary, the most common dermoscopic features of livedoid vasculopathy identified in this study were central crusted ulcers or ivory white scar-like areas associated with peripheral reticular pigmentation and increased vascular structures. The characterization of dermoscopic criteria for livedoid vasculopathy may improve the accuracy in the clinical diagnosis and follow-up of this disease.
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Affiliation(s)
- Stephen Chu-Sung Hu
- Department of Dermatology, College of Medicine, Kaohsiung Medical University
- Department of Dermatology, Kaohsiung Medical University Hospital
| | - Gwo-Shing Chen
- Department of Dermatology, College of Medicine, Kaohsiung Medical University
- Department of Dermatology, Kaohsiung Medical University Hospital
| | - Chi-Ling Lin
- Department of Dermatology, Kaohsiung Medical University Hospital
- Department of Dermatology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung
| | - Yang-Chun Cheng
- Department of Dermatology, Kaohsiung Medical University Hospital
| | - Yung-Song Lin
- Department of Otolaryngology, Chi Mei Medical Center
- Center of General education, Southern Taiwan University of Technology, Tainan City
- Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan
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27
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Long-standing Scaly Erythematous Tumor on the Lower Leg. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2016.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Villarreal-Martinez A, Chavez-Alvarez S, Herz-Ruelas M, Miranda-Maldonado I, Vázquez-Martinez O. An Atrophic Plaque with Arborizing Vessels. Case Rep Dermatol 2016; 8:239-242. [PMID: 27790113 PMCID: PMC5073680 DOI: 10.1159/000448703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 07/27/2016] [Indexed: 11/19/2022] Open
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.
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29
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Abarzúa-Araya A, Ortiz-Lazo E, González-Bombardiere S. Long-standing Scaly Erythematous Tumor on the Lower Leg. ACTAS DERMO-SIFILIOGRAFICAS 2016; 108:153-154. [PMID: 27381550 DOI: 10.1016/j.ad.2015.09.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 09/07/2015] [Accepted: 09/16/2015] [Indexed: 11/17/2022] Open
Affiliation(s)
- A Abarzúa-Araya
- Servicio de Dermatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - E Ortiz-Lazo
- Servicio de Dermatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - S González-Bombardiere
- Servicio de Anatomía Patológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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30
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Marcucci C, Sabban EC, Friedman P, Peralta R, Marull RS, Cabo H. Dermoscopic findings in a collision tumor composed of a dermatofibroma and a melanocytic nevus mimicking melanoma. Dermatol Pract Concept 2015; 5:47-9. [PMID: 26693091 PMCID: PMC4667603 DOI: 10.5826/dpc.0504a12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/13/2015] [Indexed: 11/24/2022] Open
Abstract
Collision tumors consist of two different neoplasms occurring concurrently in the same lesion. This association has been described for both benign and malignant neoplasms that may be difficult to identify. Therefore, dermoscopy is a valuable tool to make a correct diagnosis. We report a very unusual collision tumor composed of both a dermatofibroma and a melanocytic nevus mimicking melanoma.
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Affiliation(s)
| | - Emilia Cohen Sabban
- Dermatology Section, Instituto de Investigaciones Médicas “A. Lanari”, University of Buenos Aires, Argentina
| | | | | | | | - Horacio Cabo
- Dermatology Section, Instituto de Investigaciones Médicas “A. Lanari”, University of Buenos Aires, Argentina
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31
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Laureano A, Fernandes C, Cardoso J. Hemosiderotic dermatofibroma: clinical and dermoscopic presentation mimicking melanoma. J Dermatol Case Rep 2015; 9:39-41. [PMID: 26236411 DOI: 10.3315/jdcr.2015.1198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 06/27/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dermatofibromas are common benign skin neoplasms. MAIN OBSERVATIONS The authors report the clinical, dermoscopic and histopathological features of a hemosiderotic dermatofibroma mimicking melanoma in an 85-year-old woman. CONCLUSIONS Atypical dermoscopic patterns may prove difficult to differentiate from melanocytic lesions, and because of its polymorphic, melanoma-like presentation, definite diagnosis of hemosiderotic dermatofibroma can be reached by histopathological examination.
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Affiliation(s)
- André Laureano
- Department of Dermatology and Venereology, Hospital de Santo António dos Capuchos - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Cândida Fernandes
- Department of Dermatology and Venereology, Hospital de Santo António dos Capuchos - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Jorge Cardoso
- Department of Dermatology and Venereology, Hospital de Santo António dos Capuchos - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
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32
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Şenel E, Yuyucu Karabulut Y, Doğruer Şenel S. Clinical, histopathological, dermatoscopic and digital microscopic features of dermatofibroma: a retrospective analysis of 200 lesions. J Eur Acad Dermatol Venereol 2015; 29:1958-66. [DOI: 10.1111/jdv.13092] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 02/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- E. Şenel
- Faculty of Medicine; Department of Dermatology; Hitit University; Çorum Turkey
| | - Y. Yuyucu Karabulut
- Faculty of Medicine; Department of Pathology; Mersin University; Mersin Turkey
| | - S. Doğruer Şenel
- Faculty of Economics; Department of Public Administration; Anadolu University; Eskişehir Turkey
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33
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Picard A, Long-Mira E, Chuah SY, Passeron T, Lacour JP, Bahadoran P. Interest of high-definition optical coherent tomography (HD-OCT) for non-invasive imaging of dermatofibroma: a pilot study. J Eur Acad Dermatol Venereol 2015; 30:485-7. [PMID: 25588890 DOI: 10.1111/jdv.12868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Picard
- Department of Dermatology, CHU de Nice, Nice, France
| | - E Long-Mira
- Department of Pathology, LPCE, CHU de Nice, Nice, France
| | - S-Y Chuah
- Department of Dermatology, CHU de Nice, Nice, France
| | - T Passeron
- Department of Dermatology, CHU de Nice, Nice, France.,INSERM U 1065, Team 12, CHU de Nice, Nice, France
| | - J-P Lacour
- Department of Dermatology, CHU de Nice, Nice, France
| | - P Bahadoran
- Department of Dermatology, CHU de Nice, Nice, France.,INSERM U 1065, Team 1, CHU de Nice, Nice, France.,Centre de Recherche Clinique, CRC, Nice, France
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34
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Espasandín-Arias M, Moscarella E, Mota-Buçard A, Moreno-Moreno C, Lallas A, Longo C, Argenziano G. The dermoscopic variability of dermatofibromas. J Am Acad Dermatol 2015; 72:S22-4. [DOI: 10.1016/j.jaad.2014.04.048] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 04/18/2014] [Indexed: 11/30/2022]
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