# Dermatofibroma - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Dermatofibroma - StatPearls (NCBI Bookshelf NBK470538) - https://www.ncbi.nlm.nih.gov/books/NBK470538/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) - condition scope only, no dose · No dose - no medicine is given for this in primary care - Verified date: 2026-08 ## Verified against - No dose - no medicine is given for this in primary care ## Treatment metadata - No drug therapy in primary care (Assessment & Advice) ## Complete treatment card ```text DERMATOFIBROMA Sources: Dermatofibroma - StatPearls (NCBI Bookshelf NBK470538) - https://www.ncbi.nlm.nih.gov/books/NBK470538/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) - condition scope only, no dose · No dose - no medicine is given for this in primary care Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (3) - A slow-growing lesion that most often turns up on the arms or legs - Usually painless, though it can occasionally itch or feel tender [itching] - About one in five patients recall an injury at that spot, such as a shot or an insect bite SIGNS - what you find (6) - A firm, non-tender nodule under 1 cm with tan-pink to reddish-brown discoloration, though lesions over 3 cm are described - One in ten patients has more than one lesion, so a full skin check is worthwhile since they can be subtle - Pinching the skin at the edges produces a central dimple because the lesion is tethered to the tissue beneath it - Crops of multiple lesions have been reported in people on immunosuppressive therapy, those with HIV, and pregnant women - The rare metastasizing benign variant is larger than 3 cm, more cellular, has more mitotic figures, and extends into the fat below - A rare clustered variant looks like a plaque made of more than 15 reddish to hyperpigmented bumps, usually on the legs of children or young adults [plaques] TESTS (4) - Diagnosis relies mainly on how it looks and the history; a longstanding lesion should not have changed rapidly - On dermoscopy it typically shows a white center ringed by a pigmented network - Histopathology remains the reliable way to confirm the diagnosis - On pre-biopsy ultrasound it appears as a poorly marginated, spiculated, avascular dermal lesion, sometimes reaching the superficial fat IF NOT THIS - what else fits (5) - Dermatofibrosarcoma protuberans is more cellular with deeper fat involvement in a honeycomb pattern, and stains CD34 positive and factor XIIIa negative, opposite to dermatofibroma - Kaposi sarcoma tests positive for HHV-8 and can stain for CD31, CD34, and D2-40 - An intradermal nevus feels softer than a dermatofibroma and does not dimple when pinched - A keratoacanthoma grows fast and typically has a central keratin plug - Basal cell carcinoma shows peripheral palisading and CK20-positive Merkel cells within follicular induction, distinguishing it on biopsy Source StatPearls "Dermatofibroma" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (ASSESSMENT & ADVICE) [1st line] Adult A common benign firm skin nodule, most often on the lower legs, that dimples inward when pinched; diagnosed clinically and left alone unless symptomatic or diagnostically uncertain, in which case excision biopsy is offered. - Assessment and advice Peds Children follow the same pathway: assessment, explanation and follow-up. No primary-care medicine is implied. Source No dose - no medicine is given for this in primary care Why A common benign firm skin nodule, most often on the lower legs, that dimples inward when pinched; diagnosed clinically and left alone unless symptomatic or diagnostically uncertain, in which case excision biopsy is offered. Caution No medicine is prescribed for this in primary care. The value of the consultation is recognition, explanation and follow-up, and referral if the red flags above appear. RED FLAG - Rapid growth, ulceration or bleeding are atypical features for a dermatofibroma: refer for biopsy to exclude another diagnosis. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)