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INTRODUCTION

KEY POINTS

  • Dermatofibromas are solitary neoplasms that can vary in morphology and color.

  • The morphology across skin types can be flat or nodular and exophytic.

  • Dermatofibroma sarcoma protuberans is a tissue sarcoma that tends to present as keloidal-appearing nodules coalescing into plaques.

  • For both conditions, in lighter skin, it is often pink to skin colored, while in darker skin, it can be violaceous to pink-brown or gray-brown.

image

DERMATOFIBROMA

FIGURE 27-1.

Solitary dark-brown to black papule on a person with dark skin. (Reproduced with permission from Wolff K, Johnson RA, Saavedra AP, et al. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 8th ed. New York, NY: McGraw Hill; 2017, Figure 9-48B.)

FIGURE 27-2.

Solitary pink papule on a person with light skin. (Reproduced with permission from Wolff K, Johnson RA, Saavedra AP, et al. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 8th ed. New York, NY: McGraw Hill; 2017, Figure 9-48A.)

FIGURE 27-3.

Bright pink macule showing positive dimple sign on lighter skin. (Reproduced with permission from Wolff K, Johnson RA, Saavedra AP, et al. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 8th ed. New York, NY: McGraw Hill; 2017, Figure 9-48C.)

FIGURE 27-4.

Pink-brown macule with a rim of pink erythema and overlying scale exhibiting a positive dimple sign. (From Usatine RP, Smith MA, Mayeaux EJ Jr, et al. The Color Atlas and Synopsis of Family Medicine, 3rd ed. New York, NY: McGraw Hill; 2019, Figure 166-3. Reproduced with permission from Richard P. Usatine, MD.)

FIGURE 27-5.

Solitary brown-gray nodule on a person with dark skin. (From Usatine RP, Smith MA, Mayeaux EJ Jr, et al. The Color Atlas and Synopsis of Family Medicine, 3rd ed. New York, NY: McGraw Hill; 2019, Figure 110-9. Reproduced with permission from Richard P. Usatine, MD.)

FIGURE 27-6.

Dark-brown macule with a rim of pink-brown erythema on a person with dark skin. Typically on palpation, these neoplasms have underlying nodularity and a positive dimple sign. Note the flat presentation, which is in contrast to the dome-shaped morphology that can also occur. (From Usatine RP, Smith MA, Mayeaux EJ Jr, et al. The Color Atlas and Synopsis of Family Medicine, 3rd ed. New York, NY: McGraw Hill; 2019, Figure 166-2. Reproduced with permission from Richard P. Usatine, MD.)

DERMATOFIBROMA SARCOMA PROTUBERANS

FIGURE 27-7.

Pink-brown keloidal plaque with surrounding hyperpigmentation and hypopigmentation on a person ...

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