The role of dermoscopy in the recognition of dermatofibroma

Abstract

Introduction A central white scar-like patch and a delicate pigment network at the periphery are the typical signs of dermatofibromas (DFs) on dermoscopy. Aim The aim was to analyze the different dermoscopic appearances of DF. Patients and methods This study was carried out between June 2018 and June 2019 from the Dermatology Outpatient Clinic at Al Zahraa University Hospital, Al Sayed Galal University Hospital, and El-Hood El-Marsood Hospital, and included 50 cases of DF with 63 lesions of DF. Each lesion was examined by dermoscopy and histopathological examination was performed for suspicious lesions. Results A typical pattern (central white scar-like patch and peripheral pigmented network) was observed in 49 of 63 (77.7%) lesions and variants from this typical pattern included peripheral homogeneous pigmentation and central white network in two (3%) lesions, multiple white patches with peripheral pigmented network in two (3%) lesions, central homogenous pigmentation and peripheral pigmented network in one (1%) lesion, and total pigmented network in one (1%) lesion, whereas an atypical pattern, which was named the ‘nonDF-like’ pattern (1%), was seen in 14 of 63 lesions (22.2%). Atypical DFs showed features resembling different conditions such as melanoma in two (3%) lesions, psoriasis-like pattern in one (1%) lesion, basal cell carcinoma in one (1%) lesion, squamous cell carcinoma in one (1%) lesion, and aneurysmal in one (1%) lesion. Vascular patterns in our study were found in three (5%) lesions, which had a linear and dotted pattern. Conclusion DFs may display different morphological faces. The typical dermoscopic patterns allow a confident diagnosis, whereas a full surgical excision is always recommended in all doubtful cases.