Keloidal Dermatofibroma: Report of a Rare Dermatofibroma Variant in a Young White Woman

Department of Dermatology Edouard Herriot Hospital Group (Pav. R) Lyon Cedex, France.
The American Journal of dermatopathology (Impact Factor: 1.39). 06/2012; 35(3). DOI: 10.1097/DAD.0b013e31825d9d30
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    ABSTRACT: Dermatofibroma has multiple histopathological variants and overlying acanthosis, hyperkeratosis, and hyperpigmentation are often present. We have frequently observed sebaceous induction in dermatofibromas on the shoulder and wanted to assess if this is a site specific finding. We prospectively collected 100 dermatofibromas and assessed for sebaceous induction, the histopathologic pattern of the dermatofibroma, and any associated epidermal changes. We retrospectively searched for dermatofibromas with sebaceous induction to assess the anatomic site of the biopsy. In the 100 prospectively collected dermatofibromas, 49% occurred on the lower extremities, 39% on the upper extremities, 10% on the trunk, and 2% on the head. Sebaceous induction was present in 16%, and 81% with sebaceous induction occurred on or near the shoulder. The most common variant was fibrocollagenous dermatofibroma (64%), including in dermatofibromas with sebaceous induction. The retrospective search for dermatofibromas with sebaceous induction found 19 cases in which 95% occurred on shoulder area. Sclerotic pattern dermatofibromas were most common in this retrospective cohort (47%), and seborrheic keratosis-like hyperplasia occurred in 100% of these cases. Dermatofibromas occurring on the shoulder have a high incidence of sebaceous induction with seborrheic keratosis-like epidermal hyperplasia, and a fibrocollagenous or sclerotic pattern. This article is protected by copyright. All rights reserved.
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