B ackground : Dermatofibroma usually occurs on the extremities or trunk as a common and benign skin tumor. The identification of typical dermatofibroma is uncomplicated, although it can be challenge due to its wide range of presentations and histological variations. Objective : This study was undertaken to evaluate the clinical and histopathological characteristics of 147 Cases of Dermatofibroma. Methods : This is a retrospective study of 147 biopsy specimens of 124 patients who were diagnosed with dermatofibroma in the Department of Dermatology and the Department of Pathology at the Seventh Affiliated Hospital of Sun Yat-sen University between January 2009 and April 2024. All case were retrieved from the saved medical records. Results : Ages of the 124 Dermatofibroma-affected individuals ranged from 11 to 61 years with a male-to-female ratio of 1:1.7. Over 80% of the case occurred between the ages of 20 and 49 years, 61.9% of the lesions were found on the extremities. The duration of the cases varied from 17 days to 30 years and half of lesions (58.2%) persisted for less than two years. Over 60% of the lesions were found on the extremities. The diameter of the tumors ranged between 0.3 cm and 5 cm, with most tumors measuring less than or equal to 2 cm (85.00%). Cutaneous masses or dermatofibroma was the most common clinical diagnosis. Most tumors (79.6%) were asymptomatic. Cutaneous masses or dermatofibroma was the most common clinical diagnosis. Prior to the surgical procedure, 57 cases were suspected to be “DF”, 55 cases were suspected to be “cutaneous masses”. Immunohistochemical staining revealed positive expression of SMA, while the negative rate of CD34 was found to be 66.67%. No diffuse CD34 positivity was observed in all tumors. Conclusion : Variations in clinical features, pathological manifestations, and immunohistochemical results of DF pose challenges for accurate diagnosis. A comprehensive understanding of its clinical and pathological characteristics is crucial for precise identification. Incorporating immunohistochemical analysis can help prevent misdiagnosis.
Rahbari, H. and Mehregan, A.H. (1985) Adnexal Displacement and Regression in Association with Histiocytoma (Dermatofibroma). Journal of Cutaneous Pathology , 12, 94-102. https://doi.org/10.1111/j.1600-0560.1985.tb01608.x
Han, T.Y., Chang, H.S., Lee, J.H.K., Lee, W. and Son, S. (2011) A Clinical and Histopathological Study of 122 Cases of Dermatofibroma (Benign Fibrous Histiocytoma). Annals of Dermatology , 23, 185-192. https://doi.org/10.5021/ad.2011.23.2.185
Poissonnet, C.M., Burdi, A.R. and Bookstein, F.L. (1983) Growth and Development of Human Adipose Tissue during Early Gestation. Early Human Development , 8, 1-11. https://doi.org/10.1016/0378-3782(83)90028-2
Hügel, H. (2006) Fibrohistiocytic Skin Tumors. Journal der Deutschen Dermatologischen Gesellschaft , 4, 544-554. https://doi.org/10.1111/j.1610-0387.2006.06021.x
Hui, P., Glusac, E.J., Sinard, J.H. and Perkins, A.S. (2002) Clonal Analysis of Cutaneous Fibrous Histiocytoma (Dermatofibroma). Journal of Cutaneous Pathology , 29, 385-389. https://doi.org/10.1034/j.1600-0560.2002.290701.x
Yazici, A., Baz, K., Ikizoglu, G., Koca, A., Kokturk, A. and Apa, D. (2005) Familial Eruptive Dermatofibromas in Atopic Dermatitis. Journal of the European Academy of Dermatology and Venereology , 20, 90-92. https://doi.org/10.1111/j.1468-3083.2005.01357.x
Chen, T., Kuo, T. and Chan, H. (2000) Dermatofibroma Is a Clonal Proliferative Disease. Journal of Cutaneous Pathology , 27, 36-39. https://doi.org/10.1034/j.1600-0560.2000.027001036.x
Zelger, B.G. and Zelger, B. (2001) Dermatofibroma (Fibrous Histiocytoma): An Inflammatory or Neoplastic Disorder? Histopathology , 38, 379-381. https://doi.org/10.1046/j.1365-2559.2001.01131-2.x
Niemi, K.M. (1970) The Benign Fibrohistiocytic Tumours of the Skin. Acta Dermato- Venereologica , 50, 1-6.
Tsunemi, Y., Tada, Y., Saeki, H., Ihn, H. and Tamaki, K. (2004) Multiple Dermatofibromas in a Patient with Systemic Lupus Erythematosus and Sjogren’s Syndrome. Clinical and Experimental Dermatology , 29, 483-485. https://doi.org/10.1111/j.1365-2230.2004.01574.x
Chan, I., Robson, A. and Mellerio, J.E. (2005) Multiple Dermatofibromas Associated with Lupus Profundus . Clinical and Experimental Dermatology , 30, 128-130. https://doi.org/10.1111/j.1365-2230.2004.01663.x
Zaccaria, E., Rebora, A. and Rongioletti, F. (2008) Multiple Eruptive Dermatofibromas and Immunosuppression: Report of Two Cases and Review of the Literature. International Journal of Dermatology , 47, 723-727. https://doi.org/10.1111/j.1365-4632.2008.03575.x
An, İ. (2018) Multiple Eruptive Dermatofibromas in a Patient with Systemic Lupus Erythematosus Treated with Methylprednisolone. Archives of Rheumatology , 33, 236-237. https://doi.org/10.5606/archrheumatol.2018.6569
Queirós, C., Uva, L., Soares de Almeida, L. and Filipe, P. (2019) Multiple Eruptive Dermatofibromas Associated with Pregnancy—A Case and Literature Review. Dermatology Online Journal , 25, Article 12. https://doi.org/10.5070/d3255044074
Gaufin, M., Michaelis, T. and Duffy, K. (2019) Cellular Dermatofibroma: Clinicopathologic Review of 218 Cases of Cellular Dermatofibroma to Determine the Clinical Recurrence Rate. Dermatologic Surgery , 45, 1359-1364. https://doi.org/10.1097/dss.0000000000001833
Guillou, L., Gebhard, S., Salmeron, M. and Coindre, J. (2000) Metastasizing Fibrous Histiocytoma of the Skin: A Clinicopathologic and Immunohistochemical Analysis of Three Cases. Modern Pathology , 13, 654-660. https://doi.org/10.1038/modpathol.3880115
Doyle, L.A. and Fletcher, C.D.M. (2013) Metastasizing “Benign” Cutaneous Fibrous Histiocytoma: A Clinicopathologic Analysis of 16 Cases. American Journal of Surgical Pathology , 37, 484-495. https://doi.org/10.1097/pas.0b013e31827070d4
Orzan, O.A., Dorobanțu, A.M., Gurău, C.D., Ali, S., Mihai, M.M., Popa, L.G., et al . (2023) Challenging Patterns of Atypical Dermatofibromas and Promising Diagnostic Tools for Differential Diagnosis of Malignant Lesions. Diagnostics , 13, Article 671. https://doi.org/10.3390/diagnostics13040671
Mentzel, T., Wiesner, T., Cerroni, L., Hantschke, M., Kutzner, H., Rütten, A., et al . (2013) Malignant Dermatofibroma: Clinicopathological, Immunohistochemical, and Molecular Analysis of Seven Cases. Modern Pathology , 26, 256-267. https://doi.org/10.1038/modpathol.2012.157
Yanagisawa, A. and Okada, H. (2008) Nodular Fasciitis with Degeneration and Regression. Journal of Craniofacial Surgery , 19, 1167-1170. https://doi.org/10.1097/scs.0b013e318176ac1a
Vyas, T., Bullock, M.J., Hart, R.D., Trites, J.R. and Taylor, S.M. (2008) Nodular Fasciitis of the Zygoma: A Case Report. Canadian Journal of Plastic Surgery , 16, 241-243. https://doi.org/10.1177/229255030801600405
Amary, M.F., Ye, H., Berisha, F., Tirabosco, R., Presneau, N. and Flanagan, A.M. (2013) Detection of USP6 Gene Rearrangement in Nodular Fasciitis: An Important Diagnostic Tool. Virchows Archiv , 463, 97-98. https://doi.org/10.1007/s00428-013-1418-0
Shin, C., Low, I., Ng, D., Oei, P., Miles, C. and Symmans, P. (2016) USP6 Gene Rearrangement in Nodular Fasciitis and Histological Mimics. Histopathology , 69, 784-791. https://doi.org/10.1111/his.13011
Emory, T.S., Scheithauer, B.W., Hirose, T., Wood, M., Onofrio, B.M. and Jenkins, R.B. (1995) Intraneural Perineurioma: A Clonal Neoplasm Associated with Abnormalities of Chromosome 22. American Journal of Clinical Pathology , 103, 696-704. https://doi.org/10.1093/ajcp/103.6.696
Brock, J.E., Perez-Atayde, A.R., Kozakewich, H.P.W., Richkind, K.E., Fletcher, J.A. and Vargas, S.O. (2005) Cytogenetic Aberrations in Perineurioma: Variation with Subtype. American Journal of Surgical Pathology , 29, 1164-1169. https://doi.org/10.1097/01.pas.0000158397.65190.9f
Ko, E., McNamara, K., Ditty, D. and Alawi, F. (2020) Intraneural Perineurioma of the Mandible: Case Series of a Rare Entity. Oral Surgery , Oral Medicine , Oral Pathology and Oral Radiology , 130, 428-432. https://doi.org/10.1016/j.oooo.2020.07.004
Hernández-Martín, A. and Duat-Rodríguez, A. (2016) Neurofibromatosis tipo 1: Más que manchas café con leche, efélides y neurofibromas. Parte II. Actualización sobre otras manifestaciones cutáneas características de la enfermedad. NF1 y cáncer. Actas Dermo-Sifiliográficas , 107, 465-473. https://doi.org/10.1016/j.ad.2016.01.009
Linos, K., Kozel, J.A., Hurley, M.Y. and Andea, A.A. (2018) Review of the Medical Literature and Assessment of Current Utilization Patterns Regarding the Use of Two Common Fluorescence in Situ Hybridization Assays in the Diagnosis of Dermatofibrosarcoma Protuberans and Clear Cell Sarcoma. Journal of Cutaneous Pathology , 45, 905-913. https://doi.org/10.1111/cup.13345
Lassana, F.M., Coumba, B.Y., Daour, T.E.H. and Aurore, S.A. (2024) Dermatofibrosarcoma Protuberans of the Breast: A Rare Localization. Advances in Breast Cancer Research , 13, 36-42. https://doi.org/10.4236/abcr.2024.133004
Criscione, V.D. and Weinstock, M.A. (2007) Descriptive Epidemiology of Dermatofibrosarcoma Protuberans in the United States, 1973 to 2002. Journal of the American Academy of Dermatology , 56, 968-973. https://doi.org/10.1016/j.jaad.2006.09.006
Reha, J. and Katz, S.C. (2016) Dermatofibrosarcoma Protuberans. Surgical Clinics of North America , 96, 1031-1046. https://doi.org/10.1016/j.suc.2016.05.006
Acosta, A.E. and Vélez, C.S. (2017) Dermatofibrosarcoma Protuberans. Current Treatment Options in Oncology , 18, Article No. 56. https://doi.org/10.1007/s11864-017-0498-5
Liang, C.A., Jambusaria-Pahlajani, A., Karia, P.S., Elenitsas, R., Zhang, P.D. and Schmults, C.D. (2014) A Systematic Review of Outcome Data for Dermatofibrosarcoma Protuberans with and without Fibrosarcomatous Change. Journal of the American Academy of Dermatology , 71, 781-786. https://doi.org/10.1016/j.jaad.2014.03.018
Spiller, W.F. and Spiller, R.F. (1975) Cryosurgery in Dermatologic Office Practice. Southern Medical Journal , 68, 157-160. https://doi.org/10.1097/00007611-197502000-00009
Wetmore, S.J. (1999) Cryosurgery for Common Skin Lesions. Treatment in Family Physicians’ Offices. Canadian Family Physician , 45, 964-974.