Plaque-Like CD34-Positive Dermal Fibroma of the Toe: A Case Report and Review of the Literature

Plaque-like CD34-positive dermal fibroma (PDF) is a rare, benign cutaneous neoplasm that is most commonly seen on the neck or trunk of young females. Diagnosis of PDF can be challenging due to its clinical heterogeneity and immunohistochemical overlap with other spindle cell neoplasms. We report the case of a 57-year-old female who presented with a painless, slowly enlarging pigmented macule on the dorsal aspect of her left first toe. Histopathologic analysis revealed a proliferation of wavy and spindle-shaped fibroblasts interwoven within the dermis, with immunohistochemistry showing strong CD34 positivity, consistent with a diagnosis of PDF. A comprehensive review of the literature was conducted to evaluate previously reported cases and anatomical distributions of PDFs. This review identified no prior reports of PDF involving the digits. To the best of our knowledge, this is the first documented case of a PDF occurring on the toe.