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Lichenoid, erosive and ulcerated dermatofibromas. Three additional clinico-pathologic variants
E Sánchez Yus1, L Soria, E de Eusebio
1Department of Dermatology of the Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
Journal of Cutaneous Pathology
|March 23, 2000
Summary
Dermatofibromas can rarely present with lichenoid, erosive, or ulcerated features, complicating clinical diagnosis. However, these epidermal changes in histologically typical dermatofibromas do not indicate malignancy.
Area of Science:
- Dermatopathology
- Oncology
- Dermatology
Background:
- Dermatofibromas typically exhibit epidermal hyperplasia.
- Unusual epidermal destruction patterns in dermatofibromas are infrequently reported.
- Clinical diagnosis of dermatofibromas can be challenging with atypical features.
Purpose of the Study:
- To investigate dermatofibroma cases with epidermal destruction.
- To analyze the clinical and histological features of these variants.
- To determine if epidermal changes suggest malignancy.
Main Methods:
- Retrospective review of 484 dermatofibroma cases.
- Identification of cases with lichenoid, erosive, or ulcerated epidermis.
- Histopathological and follow-up analysis.
Main Results:
- Eleven cases with epidermal destruction were identified: 3 lichenoid, 6 erosive, 2 ulcerated.
- Lichenoid cases showed basal cell squamotization and clefting.
- Erosive and ulcerated cases often lacked inflammation or signs of trauma.
- Clinical diagnosis was uncertain in most cases.
Conclusions:
- Lichenoid, erosive, and ulcerated changes are rare in dermatofibromas, potentially hindering clinical diagnosis.
- These epidermal alterations in histologically confirmed dermatofibromas are not indicative of malignancy.
- Histopathology remains crucial for accurate diagnosis and reassurance.