Dermatofibromas are very common. They are most frequently seen in the age range of 20-50 years and are four times more common in women than in men. A dermatofibroma usually remains unchanged in the skin and does not disappear on its own, similar to other scar processes in the skin.
Dermatofibromas appear as small (approximately 4-8 mm in size) solitary skin tumors. They can vary in colour, including skin-coloured, yellow-brown, and light pink. In dark skin, they are often brownish or black.
Dermatofibromas can occur anywhere on the body but are most commonly found on the arms and legs (especially the front of the lower legs). They develop slowly and are generally stable in size and appearance. These skin changes rarely cause any symptoms, and only a few may feel tender or itchy. The diagnosis is made based on a clinical examination, often with the assistance of a dermatoscope. A dermatofibroma typically feels like a hard, non-tender nodule in the skin. In cases of uncertainty, surgical removal of the skin lesion or a biopsy (tissue sample) may be indicated for further examination.
Dermatofibromas are interpreted as scar-like reactions to minor skin injuries and/or inflammation. Minor injuries (such as shaving-related trauma), insect bites, and folliculitis can be triggering factors, but in most cases, the exact cause is unknown.
Dermatofibromas are benign and do not require treatment. In rare cases, surgical removal of the skin lesion may be performed to confirm the diagnosis or to address patient discomfort or self-consciousness. However, surgical procedures, especially on the front of the lower leg, carry a significant risk of prominent scarring. All excised skin lesions are sent for microscopic examination (histopathology) to confirm the diagnosis.
As with all skin tumors, it is important to distinguish between benign and malignant lesions. Dermatofibromas can somewhat resemble various malignant skin lesions (including basal cell carcinoma). However, dermatofibromas remain stable in size and appearance, unlike cancerous skin processes. Skin lesions that are rapidly growing or changing should always be examined, as well as those with increasing symptoms or ulceration and crusting.
