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Healthful Hints: Don't be afraid of dermatofibromas

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It may be time to recall what a dermatofibroma is, after recently seeing a few of these growths on patients that had raised questions in their minds and prompted visits, Dermatofibromas are likely one of the most common growths you have never encountered. It is worth knowing about, so there is one less growth to cause the protuberance paranoia pervasive in so many people.

The word translates into a lump (-oma) of connective tissue (fybro-) in your dermis (dermato-), the lower portion of your skin. A dermatofibroma is usually a smaller, smooth, firm, bump. The fibrous cells and tissue are about the same consistency as that found in a scar, which accounts for the hardness. It is pigmented with shades of brown about 75-80% of the time, making people think it’s a kind of mole. Moles, however, are pigment cell growths, and biologically unrelated.

Most dermatofibromas are a few millimeters to a quarter or half an inch wide. Some can oddly get large. Their cause or origin is totally unknown. They generally occur with no preceding sign or sensation or injury, like a cut, and will grow to a certain size, and stay there, not changing for the rest of its life. Nobody has tracked these to see if and when they disappear. But older citizens seem to lack them. If they had any, they probably went to that big dermis in the sky. The crucial point to make about them is they have NO malignant potential, period.

Dermatofibromas most often pop up on legs and thighs but can erupt on arms and torsos without asking. They are more common on females’ legs than males’ legs. This brings up the question of whether shaving legs starts them. Yet, most males don’t shave their legs and some still develop them. I used to have one on my belly, and I never shaved my tummy, honest. They can call anywhere on your body home except head and face. (Good!)

Most often you grow only one of them, but a few folks foster more, especially those with suppressed immunity, enhancing the confusion over their origin. They are still harmless. They rarely appear before adolescence.

They can be confused with other growths, especially melanoma if they become darkly pigmented in darker skin-toned individuals. Then, the wisdom is to remove them for a biopsy, so there is no potential of missing something that turns into a problem.

Treatment is either recognition of and indifference toward them, or, (if they are in the way of leg shaving and induce repeated nicking and bloodletting) cutting them off. The latter is an option to flatten the terrain. It will always leave a flat line scar in place of the bump. Removal for peace of mind may be therapeutic for some.

Why do they come? Nobody knows, despite theoretical conjectures. Suffice it to say, in an era of introspection about our cutaneous topography, a dermatofibroma is no problem. Should we label repeated skin examination “extrospection”?

Dr. Bures, a semi-retired dermatologist, since 1978 has worked Winona, La Crosse, Viroqua and Red Wing. He also plays clarinet in the Winona Municipal Band and a couple dixieland groups. And he does enjoy a good pun.


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