Dermatofibrome
Révision par les pairs par le Dr Toni Hazell, MRCGPDernière mise à jour par Dr Rosalyn Adleman, MRCGPDernière mise à jour : 14 mars 2025
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Dans cet article :
Synonym: fibrous histiocytoma
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What are dermatofibromas?
Dermatofibromas are common and benign skin tumours but frequently cause concern upon discovery.
Causes of dermatofibromas (aetiology)
Traditionally, dermatofibromas were attributed to a reaction to trauma such as insect bites. However, the precise aetiology is unclear. Some believe them to be benign neoplasms rather than reactive in origin.
The most common dermatofibromas contain a mixture of fibroblasts, macrophages and blood vessels. Most involve the dermis and may extend to the subcutis. A number of less common variants where the histology differs, such as the aneurysmal fibrous histiocytoma, hemosiderotic fibrous histiocytoma, cellular fibrous histiocytoma and epithelioid fibrous histiocytoma, have been described.1 Different types are associated with different behaviours and outcomes.
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How common are dermatofibromas? (Epidemiology) 23
They are common but determining global incidence is challenging as most patients are asymptomatic and do not seek medical attention.
They are more frequent in women than in men.
They can occur at any age, most commonly in young adulthood.
They occur in all ethnicities.
They are more common and more numerous in those with immunosuppression.
Symptoms of dermatofibromas (presentation)3 4
Dermatofibromas are usually single nodules that develop on an extremity, most commonly the lower legs. They are freely moving, firm-to-hard nodules of 0.5-1.0 cm diameter.
The skin's surface is generally smooth, occasionally scaly. The overlying skin may be tethered, causing it to dimple when pinched. The skin colour varies from skin-coloured to pink/red to cream/white to brown.
Dermatofibromas can occur at any skin site and individuals may have several lesions (up to 15).
Multiple variants tend to occur where immunity is impaired (eg, autoimmune disease, systemic lupus erythematosus, HIV, leukaemia).
The nodule is usually asymptomatic but can be itchy or tender.
After initial growth, they tend to remain static in size.
Dermatofibroma - close-up view

Par Mohammad2018, CC BY-SA 4.0via Wikimedia Commons
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Diagnosis of dermatofibromas
Diagnosis is usually straightforward provided you palpate the lesion, as few other skin lesions are as firm.
The pinch test is helpful (but not definitive): squeezing the lesion from the sides results in dimpling of overlying skin.
With a dermatoscope, dermatofibromas typically show a pigment network and central white patch but there is considerable variation.5 One study noted a difference in dermatoscopy appearance depending on location of the lesion.6
Excision biopsy is useful where diagnostic uncertainty remains after examination.
Diagnostic différentiel
Comprend :
Keloid or hypertrophic scar.
Metastatic carcinoma of the skin.
Naevus de Spitz.
Deep penetrating dermatofibromas may be difficult to distinguish, even histologically, from rare malignant fibrohistiocytic tumours - eg, dermatofibrosarcoma protuberans.7
Management of dermatofibromas
Reassure - generally no treatment is required.
Remove where cosmetically disliked, symptomatic or there is diagnostic uncertainty. Note that there is a significant local recurrence rate.
Removal by elliptical excision or punch biopsy usually provides the most satisfactory results: shave excision or cryotherapy have higher risks of incomplete excision and recurrence.
A Dutch study showed about 2% of GP subcutis excisions yield unexpected or rare malignancies, and UK studies have shown a lack of reliability in GP diagnosis of skin malignancy.8 9 Therefore, even where excision is for cosmetic or symptomatic reasons, it is nonetheless worth sending specimens to histology.
Quand référer
Referral is normally indicated only for diagnostic uncertainty, to differentiate from other potentially harmful pigmented lesions.
Pronostic
Dermatofibromas are almost invariably benign - there are extremely rare case reports of metastasising cellular dermatofibromas, although histological distinction from other tumours can prove difficult.10 Follow up lesions that are histologically atypical or undergo recurrence.
Most are static and persist indefinitely although, uncommonly, they spontaneously regress.
The cellular type tends to become larger and, as above, has occasionally been reported to metastasise.
They may become repeatedly irritated - by shaving, for example.
Autres lectures et références
- Higgins JC, Maher MH, Douglas MSDiagnostic des tumeurs cutanées bénignes courantes. Am Fam Physician. 2015 Oct 1;92(7):601-7.
- Marghoob AA, Usatine RP, Jaimes NDermoscopie pour le médecin de famille. Am Fam Physician. 2013 Oct 1;88(7):441-50.
- Myers DJ, Fillman EP; Dermatofibroma. StatPearls, Sept 2021.
- Dermatofibrome; DermIS.
- Alves JV, Matos DM, Barreiros HF, et al; Variants of dermatofibroma--a histopathological study. An Bras Dermatol. 2014 May-Jun;89(3):472-7.
- Myers DJ, Fillman EP. Dermatofibroma. [Updated 2024 Feb 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan
- DermatofibromeSociété de dermatologie en soins primaires
- DermatofibromeDermNet NZ
- Zaballos P, Puig S, Llambrich A, et al; Dermoscopy of dermatofibromas: a prospective morphological study of 412 cases. Arch Dermatol. 2008 Jan;144(1):75-83.
- Brancaccio G, Nuzzo T, Di Maio R, et al; Dermatofibroma looks dermoscopically different on trunk vs extremities. G Ital Dermatol Venereol. 2015 Dec 23.
- Hanly AJ, Jorda M, Elgart GW, et al; High proliferative activity excludes dermatofibroma: report of the utility of MIB-1 in the differential diagnosis of selected fibrohistiocytic tumors. Arch Pathol Lab Med. 2006 Jun;130(6):831-4.
- Buis PA, Verweij W, van Diest PJ; Value of histopathologic analysis of subcutis excisions by general practitioners. BMC Fam Pract. 2007 Jan 26;8:5.
- George S, Pockney P, Primrose J, et al; A prospective randomised comparison of minor surgery in primary and secondary care. The MiSTIC trial. Health Technol Assess. 2008 May;12(23):iii-iv, ix-38.
- Bandarchi B, Ma L, Marginean C, et al; D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans. Mod Pathol. 2010 Mar;23(3):434-8. Epub 2010 Jan 8.
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Historique de l'article
Les informations contenues dans cette page sont rédigées et évaluées par des cliniciens qualifiés.
Prochaine révision prévue : 13 mars 2028
14 Mar 2025 | Dernière version

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