Dermatofibromas are common cutaneous lesions. In most cases, they can be readily identified clinically and show a typical histology. In a small percentage of cases they show unusual clinical and more often histologic features that may cause differential diagnostic problems. In addition there are reactive fibrous lesions with neural or smooth muscle features that we speculate may represent dermatofibroma variants.
LeBoit PE, Burg G, Weedon D, Sarasin A (eds): Pathology and genetics of skin tumors. In World Health Organization (WHO) classification of tumors, by Kleihues P, Sobin L, IARC Press, Lyon, 2004 (in press)
2.
Headington JT. The histiocyte: In memoriam. Arch Dermatol122:532-5331986
3.
Foucar K, Foucar E. The mononuclear phagocyte and immunoregulatory effector (M-PIRE) system: Evolving concepts. Semin Diagn Pathol7:4-181990
4.
Senear FE, Caro MR. Histiocytoma cutis. Arch Dermatol Syphilol33:209, 1936
5.
Ackerman AB, Chongchitnant N, Sanchez J, Guo Y, Bennin B, Reichel M, Randall MB (eds). Histologic diagnosis of inflammatory skin disorders. An algorithmic method based on pattern analysis, 2nd ed.Williams and Wilkins, Baltimore, 1997
Aiba S, Terui T, Tagami H. Dermatofibroma with diffuse eosinophilic infiltrate. Am J Dermatopathol22:281-2842000
8.
Sanchez Yus E, Soria L, de Eusebio E, Requena L. Lichenoid, erosive and ulcerated dermatofibromas. Three additional clinico-pathologic variants. J Cutan Pathol27:112-1172000
Rapini RP, Golitz LE. Sclerotic fibromas of the skin. J Am Acad Dermatol20:266-2711989
11.
Kuo TT, Hu S, Chan HL. Keloidal dermatofibroma. Report of 10 cases of a new variant. Am J Surg Pathol22:564-5681998
12.
Gross RE, Wolbach SB. Sclerosing hemangiomas: Their relationship to dermatofibroma, histiocytoma, xanthoma and to certain pigmented lesions of the skin. Am J Pathol19:533-5511943
13.
Weiss SW, Goldblum JR (eds). Enzingerś Soft tissue tumors, 4th ed.Mosby, St.Louis, pp. 441-490, 2001
14.
Burgdorf W, Moreland A, Wasik R. Negative immunoperoxidase staining for lysozyme in nodular subepidermal fibrosis. Arch Dermatol118:241-2431982
15.
Zelger BG, Sidoroff A, Zelger B. Combined dermatofibroma: Co-existence of two or more variant patterns in a single lesion. Histopathology36:529-5392000
16.
Sanchez RL. The elusive dermatofibromas. Arch Dermatol126:522-5231990
17.
Wilson Jones E, Cerio R, Smith NP. Epithelioid cell histiocytoma: A new entity. Br J Dermatol120:185-1951989
18.
Beer M, Eckert F, Schmöckel CH. The atrophic dermatofibroma. J Am Acad Dermatol25:1081-10821991
19.
Schaller J, Rohwedder A, Burgdorf WH, Itin PH, Lautenschlager S. Identification of human papilloma virus DNA in cutaneous lesions of Cowden syndrome. Dermatology207:134-1402003
20.
Santa Cruz DJ, Kyriakos M. Aneurysmal (“angiomatoid”) fibrous histiocytoma of the skin. Cancer47:2053-20611981
21.
Calonje E, Fletcher CDM. Aneurysmal benign fibrous histiocytoma: Clinicopathological analysis of 40 cases of a tumour frequently misdiagnosed as a vascular neoplasm. Histopathology26:323-3311995
22.
Enzinger FM. Angiomatoid malignant fibrous histiocytoma: A distinct fibrohistiocytic tumor of children and young adults simulating a vascular neoplasm. Cancer44:2147-21571979
23.
Fletcher CDM, Unni KK, Mertens F (eds). Pathology and genetics of tumours of soft tissue and bone. In World Health Organization (WHO) classification of tumours, by Kleihues P, Sobin L, IARC Press, Lyon, 2002
24.
Zelger BG, Zelger B. Dermatofibrome. Ein klinischpathologisches Klassifikationsschema. Pathologe19:412-4191998
25.
Kamino H, Jacobson M. Dermatofibroma extending into the subcutaneous tissue. Am J Surg Pathol14:1156-11641990
26.
Zelger B, Sidoroff A, Stanzl U, Fritsch P, Öfner D, Zelger BG, Jasani B, Schmid KW. Deep penetrating dermatofibroma versus dermatofibrosarcoma protuberans—a clinicopathologic comparison. Am J Surg Pathol18:677-6861994
27.
Weedon D (ed). Skin pathology. Edinburgh, Churchill-Livingstone, pp. 930-933, 1997
28.
Hunt SJ, Santa Cruz DJ, Miller CW. Cholesterotic fibrous histiocytoma: Its association with hyperlipoproteinemia. Arch Dermatol126:506-5081990
29.
Iwata J, Fletcher CDM. Lipidized fibrous histiocytoma. Clinicopathologic analysis of 22 cases. Am J Surg Pathol22:126-1342000
30.
LeBoit PE, Barr RJ. Smooth-muscle proliferation in dermatofibromas. Am J Dermatopathol16:155-1601994
31.
Ackerman AB, Reddy VB, Soyer HP (eds). Neoplasms with follicular differentiation. Ardor Scribendi, Ltd., New York, 2001
32.
Calonje E, Fletcher CDM. Cutaneous fibrohistiocytic tumors: An update. Adv Anat Pathol1:2-151994
33.
Zelger B, Zelger BG, Steiner H, Öfner D. Aneurysmal and haemangiopericytoma-like fibrous histiocytoma. Clinical and histological pitfalls in the diagnosis of vascular lesions. J Clin Pathol49:313-3181996
Silverman JS, Brustein S. Myxoid dermatofibrohistiocytoma: An indolent post-traumatic tumor composed of CD34+ epithelioid and dendritic cells and factor XIIIa+ dendrophages. J Cutan Pathol23:551-5571996
36.
Zelger BG, Calonje E, Zelger B. Myxoid dermatofibroma. Histopathology34:357-3641999
37.
Kuo T, Chan HL. Ossifying dermatofibroma with osteoclast-like giant cells. Am J Dermatopathol16:193-1951994
38.
Glusac EJ, Madison McNiff J. Epithelioid cell histiocytoma: A simulant of vascular and melanocytic neoplasms. Am J Dermatopathol21:1-71999
39.
Calonje E, Mentzel TH, Fletcher CDM. Cellular benign fibrous histiocytoma. Clinicopathologic analysis of 74 cases of a distinctive variant of cutaneous fibrous histiocytoma with frequent recurrence. Am J Surg Pathol18:668-6761994
40.
Zelger B, Steiner H, Kutzner H. Clear cell dermatofibroma. Case report of an unusual fibrohistiocytic lesion. Am J Surg Pathol20:483-4911996
41.
Paties C, Vassallo G, Taccagni G. Clear cell dermatofibroma (letter). Am J Surg Pathol21:250, 1997
42.
Val-Bernal JF, Mira C. Dermatofibroma with granular cells. J Cutan Pathol23:562-5651996
43.
Zelger B, Burgdorf WH. The cutaneous “histiocytoses.”Adv Dermatol17:77-114, 2001
44.
Regezi JA, Nickoloff BJ, Headington JT. Oral submucosal dendrocytes: Factor XIIIa+ and CD34+ dendritic cell populations in normal tissue and fibrovascular lesions. J Cutan Pathol19:398-4061992
45.
Nestle FO, Nickoloff BJ, Burg G. Dermatofibroma: An abortive immunoreactive process mediated by dermal dendritic cells? Dermatology190:265-2681995
46.
Cerio R, Spaull J, Wilson Jones E. Histiocytoma cutis: A tumour of dermal dendrocytes (dermal dendrocytoma). Br J Dermatol120:197-2061989
47.
Nath R, Kambadur R, Gulati S, Paliwal VK, Sharma M. Molecular aspects, physiological functions, and clinical significance of metallothioneins. Crit Rev Food Sci Nutr27:41-851988
48.
Zelger B, Zelger BG, Rappersberger K. Myofibroblastic differentiation—a pitfall in the diagnosis of dermatofibroma. Am J Dermatopathol19:138-1461997
49.
Pitha J, Smoller BR, Somach S, McCalmont TH. A spindled cell CD34+ dermal proliferation. Am J Dermatopathol24:85-882002
50.
Zelger B. It’s a dermatofibroma, CD34 is irrelevant! Am J Dermatopathol24:453-454, 2002
51.
Zelger BG, Zelger B. Dermatofibroma (fibrous histiocytoma): An inflammatory or neoplastic disorder? Histopathology38:379-3812001
52.
Calonje E. Is cutaneous benign fibrous histiocytoma (dermatofibroma) a reactive inflammatory process or a neoplasm? Histopathology37:278-2802000
53.
Colome-Grimmer MI, Evans HL. Metastasizing cellular dermatofibroma. A report of two cases. Am J Surg Pathol20:1361-13671996
54.
Colby TV. Metastasizing dermatofibroma. Am J Surg Pathol21:976, 1997
55.
Guillou L, Gebhard S, Salmeron M, Coindre JM. Metastasizing fibrous histiocytoma of the skin: A clinicopathologic and immunohistochemical analysis of three cases. Mod Pathol13:654-6602000
56.
Vanni R, Fletcher CDM, Sciot R, Dal Cin P, De Wever I, Mandahl N, Mertens F, Mitelman F, Rosai J, Rydholm A, Tallini G, van den Berghe H, Willen H. Cytogenetic evidence of clonality in cutaneous benign fibrous histiocytomas: A report of the CHAMP study group. Histopathology37:212-2172000
57.
Chen TC, Kuo TT, Chan HL. Dermatofibroma is a clonal proliferative disease. J Cutan Pathol27:36-392000
Mentzel T, Kutzner H, Rütten A, Hügel H. Benign fibrous histiocytoma (dermatofibroma) of the face: Clinicopathologic and immunohistochemical study of 34 cases associated with an agressive clinical course. Am J Dermatopathol23:419-4262001
60.
Tamada S, Ackerman B. Dermatofibroma with monster cells. Am J Dermatopathol9:380-3871987
Wilson Jones E, Cerio R, Smith NP. Multinucleate cell angiohistiocytoma: An acquired vascular anomaly to be distinguished from Kaposiś sarcoma. Br J Dermatol122:651-6631990
63.
Hügel H. Die plaqueförmige dermale Fibromatose. Hautarzt42:223-2261991
64.
Kamino H, Reddy VB, Gero M, Greco MA. Dermatomyofibroma—a benign cutaneous, plaque-like proliferation of fibroblasts and myofibroblasts in young adults. J Cutan Pathol19:85-931992
65.
Gallager RL, Helwig EB. Neurothekeoma: A benign cutaneous tumor of neural origin. Am J Clin Pathol74:759-7641980
66.
Glusac EJ, Barr RJ, Everett MA, Pitha J, Santa Cruz DJ. Epithelioid cell histiocytoma. A report of 10 cases including a new cellular variant. Am J Surg Pathol18:583-5901994
67.
Zelger BG, Steiner H, Kutzner H, Maier H, Zelger B. Cellular “neurothekeoma”: An epithelioid variant of dermatofibroma? Histopathology32:414-4221998
68.
Barnhill RL, Dickersin R, Nickeleit V, Bhan AT, Muhlbauer JE, Phillips ME, Mihm MC Jr. Studies on the cellular origin of neurothekeoma: Clinical, light microscopic, immunohistochemical and ultrastructural observations. J Am Acad Dermatol25:80-881991
69.
Calonje E, Wilson-Jones E, Smith NP, Fletcher CDM. Cellular “neurothekeoma”: An epithelioid variant of pilar leiomyoma? Morphological and immunohistochemical analysis of a series. Histopathology20:397-4041992
70.
Argenyi Z, LeBoit PE, Santa Cruz D, Swanson PE, Kutzner H. Nerve sheath myxoma (neurothekeoma) of the skin: Light microscopic and immunohistochemical reappraisal of the cellular variant. J Cutan Pathol20:294-3031993
71.
Husain S, Silvers DN, Halperin AJ, McNutt NS. Histologic spectrum of neurothekeoma and the value of immunoperoxidase staining for S100 protein in distinguishing it from melanoma. Am J Dermatopathol16:496-5031994
72.
Argenyi ZB, Kutzner H, Seaba MM. Ultrastructural spectrum of cutaneous nerve sheath myxoma/cellular neurothekeoma. J Cutan Pathol22:137-1451995
73.
Mentzel T Calonje E, Fletcher CDM. Cellular “neurothekeoma:“ Correction of a mistaken hypothesis. Dermatopathology: Practical & Conceptual2:237-2401996
74.
Harkin JC, Reed RJ. Tumors of the peripheral nervous system. In Atlas of tumor pathology, 2nd ed., fascicle 3. Armed Forces Institute of Pathology, Washington, DC, pp 60-64, 1969
75.
Angervall L, Kindblom LG, Haglid K. Dermal nerve sheath myxoma. A light and electron microscopic, histochemical and immunohistochemical study. Cancer53:1752-17591984