Dermatofibroma Differential Diagnosis Table

Dermatofibroma Differential Diagnosis Table:

Dermatofibroma is an overgrowth of fibrous tissue. It’s a benign growth and usually appears on the lower leg, where it may look purple in color. The exact cause of dermatofibroma is not known, but it’s been said that it may be because of past trauma or an injury in the same place. It can affect anyone, but usually, it affects people aged 20-40 years old.
Since dermatofibroma is completely harmless, treatment is often not required, and most often, dermatofibromas will go away on their own. But some treatments do exist, and they can help.
Diagnosis of dermatofibroma mainly depends on clinical examination by the doctor, but sometimes a local procedure with anesthesia may be needed to remove a part of the dermatofibroma tissue to be examined under a microscope.
Dermatofibroma has a very unique sign when you press on your skin with lateral pressure, called the dimple sign, which is very characteristic of dermatofibroma.

How To Distinguish Dermatofibroma from Other Diseases

Distinguish Benign Fibrous Histiocytoma from Dermatofibroma – Diagnosis

Benign fibrous histiocytoma is a rare mesenchymal tumor. It usually occurs in sun-exposed areas, but it can occur anywhere in the body, and although it’s not cancerous, it may require treatment. The likelihood of malignant transformation is rare too.

• MRI, CT scan, or X-ray can help in the diagnosis of benign fibrous histiocytoma by their radiographic appearance.
• Your doctor may need a tissue biopsy for histopathological examination to confirm benign growth too.

Distinguish Connective Tissue Nevus from Dermatofibroma – Diagnosis

Connective tissue nevi are skin lesions that are characteristic of abnormal growth of the skin layer due to an increase in the production of collagen and elastin. They usually appear during birth, but they can occur later in life. They may appear on the skin as the same color and may have different brown or yellow colors.

• Histopathological examination is the main diagnostic test. It shows an increase in the production of collagen in comparison to normal skin.

Distinguish Basal Cell Carcinoma from Dermatofibroma – Diagnosis

Basal cell carcinoma is the most common type of skin cancer. It usually occurs due to long exposure to the sun and UV lights, affecting the exposed areas of the skin more often, like the neck and face. Basal cell carcinoma is treatable, and early diagnosis and treatment can lead to a good prognosis.

• The most diagnostic test for basal cell carcinoma is a skin biopsy.
• MRI, CT scan, or even PET scan are sometimes needed to make sure the cancer hasn’t reached any organs or lymph nodes.

Distinguish Lipoma from Dermatofibroma – Diagnosis

Lipoma is a slowly growing lump of fatty tissue. It’s very soft and mobile. Lipomas are very common and affect mainly people aged 40-60 years old. It’s completely harmless, and no need for treatment, but people prefer to remove it surgically.

• A biopsy is usually the most diagnostic test in the case of lipoma, and it helps to differentiate whether it’s a benign or cancerous growth like liposarcoma.
• X-ray and MRI help in diagnosis as well. They help to know the extent and the depth of the lipoma and differentiate between it and cysts.

Distinguish Hemangioma from Dermatofibroma – Diagnosis

Hemangioma, also called infantile hemangioma, is a growth of blood vessels that appears in newborns and grows gradually. It’s benign and doesn’t require treatment if it doesn’t affect any crucial part of the body. It will continue to grow until it enters a rest phase, then starts to slowly fade. Hemangiomas are divided into subtypes: Superficial, deep, and mixed. They often appear as red, spongy bumps.

• Hemangiomas don’t usually need any tests; doctors can diagnose it based on its appearance.
• In some cases, an ultrasound may be needed to see if hemangioma is affecting any internal organ and to have a close look at it.

Distinguish Keloid from Dermatofibroma – Diagnosis

A keloid is a scar that usually happens after trauma, injury, or a burn, where the skin heals with so much production of collagen, leaving a scar with a hard raised brown texture. It’s completely harmless. It tends to happen in some people more than others, and people with keloid scars usually have more than one.

• Keloids are usually diagnosed by their appearance, with no other tests needed.
• Sometimes, a biopsy is required to confirm the keloid and rule out any cancerous skin.

Distinguish Pyogenic Granuloma from Dermatofibroma – Diagnosis

Pyogenic granulomas are small, bloody, raised red bumps that are caused by abnormal blood vessels that break easily. The bumps have a high tendency for bleeding because they’re filled with blood capillaries. Pyogenic granulomas can happen due to hormonal changes, which is why they’re very common during pregnancy.

• Pyogenic granuloma is often diagnosed with a physical examination and the patient’s past medical history, as they can occur due to infection, medication, or hormonal changes.
• A skin biopsy is often required to rule out skin cancer and basal cell carcinoma.

Distinguish Angioma from Dermatofibroma – Diagnosis

Angiomas are benign tumors consisting of blood vessels. They are often small raised bumps that are harmless. The cause of angioma is unknown, but some link it to liver diseases that affect coagulopathy. Angiomas usually don’t require treatment, but people will most likely remove them for a better appearance. There are two types of angioma: cherry angioma and spider angioma.

• Angiomas are usually diagnosed only by their appearance, without any further investigations.
• Rarely, a biopsy from an angioma can help rule out any other skin condition or malignancy.

Distinguish Neurofibroma from Dermatofibroma – Diagnosis

Neurofibromas are benign tumors that arise from nerves, either small or big nerves or even nerve bundles. They can arise either on the skin or under it. Neurofibromas can develop as symptoms of a genetic condition called neurofibromatosis. There are many types of neurofibromas, and although they are benign, there’s a 10% chance neurofibromas can be cancerous.

• MRI and CT scan are usually used to detect any nerve abnormalities.
• Nerve conduction, along with EMG, can also be used to see any change in the function of the nerve.
• A PET scan may be needed to give a more visual image than MRI and CT scan if it can’t be differentiated.

“Since neurofibromas have different types, their look on the skin is often different regarding their type; they can look like flesh-colored nodules, red raised bumps, or very large lumps.”

Distinguish Dermatofibrosarcoma Protuberans from Dermatofibroma – Diagnosis

Dermatofibrosarcoma protuberans is a very rare type of malignant skin cancer. It grows very slowly, usually appearing as a small bump or bruise on the skin that is very firm and starts to grow slowly, but it doesn’t normally spread. Though the tumor should be surgically removed to prevent any chance of spreading.

• Skin biopsy is usually used as the most diagnostic method in dermatofibrosarcoma protuberans, where a piece of the skin is removed and examined by histopathology.
• MRI can help in the investigation of the tumor, especially before surgery to know the depth of the tumor since clinical examination is not reliable.

Important Red Flags in Dermatofibroma

Since most of the above-mentioned diseases are similar and usually, the main diagnosis starts with the clinical appearance, it’s important to seek a doctor once you experience any skin lesion.
Dermatofibromas are completely harmless. Often there is nothing to worry about, but if your skin lesion is changing sizes or colors, it may be an indication of a cancerous growth.
Another thing in dermatofibroma is that it’s rarely painful, so if you experience any pain, it’s better to see your doctor.