Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter To Editor
2007:73:3;194-195
doi: 10.4103/0378-6323.32747
PMID: 17558056

Multiple dermatofibromas on face treated with carbon dioxide laser

DS Krupa Shankar, AA Kushalappa, KS Suma, Sanjay A Pai
 Department of Dermatology, Manipal Hospital, Bangalore, India

Correspondence Address:
D S Krupa Shankar
Department of Dermatology, Manipal Hospital, 98, Rustom Bagh, Airport Road, Bangalore
India
How to cite this article:
Krupa Shankar D S, Kushalappa A A, Suma K S, Pai SA. Multiple dermatofibromas on face treated with carbon dioxide laser. Indian J Dermatol Venereol Leprol 2007;73:194-195
Copyright: (C)2007 Indian Journal of Dermatology, Venereology, and Leprology
Figure 2: Multiple dermatofi bromas of the face before and after CO2 laser therapy
Figure 2: Multiple dermatofi bromas of the face before and after CO2 laser therapy
Figure 1: A well circumscribed benign spindle cell lesion in the dermis (H and E, x100)
Figure 1: A well circumscribed benign spindle cell lesion in the dermis (H and E, x100)

Sir,

Dermatofibroma is a benign tumor which is a generally a single round or ovoid papule or nodule about 0.5 mm to 1 cm in diameter, is reddish brown, sometimes with a yellowish hue. The commonest sites include thighs, legs or arms and affection of face is rare. We came across an unusual case of multiple dermatofibromas on the face and the trunk.

A 58-year-old man presented with skin-colored papules and nodules over the face, arms and trunk. He initially noticed one of them at the right outer angle of the eye. Lesions then appeared over the cheeks, eyelids, chin, neck, chest and arms. Gradually over a period of eight months, two lesions regressed spontaneously on the face. The patient had no history of medication for any illness. There was no relevant family or personal history.

Cutaneous examination revealed dry, firm to hard, round to oval, skin-colored nodules, ranging from one millimeter to two centimeters with regular borders. The lesions were scattered, regional and bilaterally symmetrical. The conjunctiva, mouth, scalp, hair and nails were normal. There were no cafι′ au lait macules. A clinical differential diagnosis of neurofibroma or xanthoma was considered.

One of the nodules on the face was excised with carbon dioxide laser and submitted for histopathological evaluation [Figure - 1]. A diagnosis of dermatofibroma was made. Subsequently, six lesions were excised using carbon dioxide laser with histology again showing features of dermatofibroma. Satisfactory healing was noted at one week and one month following excisions without significant scarring [Figure - 2]. The patient has been followed-up for eight months without any recurrences.

Dermatofibroma is characterized by a nodular cellular proliferation of fibroblasts in a criss-cross or storiform pattern in the dermis. Further, multinucleate giant cells and foam cells were also seen in our patient a feature that is common in dermatofibromas. Neurofibroma was ruled out as a possible diagnosis in the absence of cells with wavy nuclei or evidence of specific neurogenic differentiation. [1] Also retrospectively, a history of spontaneous remission of two lesions is consistent with a diagnosis of dermatofibroma. As simple excision was precluded given the number, size and location of the lesions, carbon dioxide laser was used to get a bloodless excision and wound contraction leading to a scar-free excision.

Dermatofibroma is believed to be a pattern of dermal response to injury such as insect bites. Whether its cell of origin is the fibroblast or histiocyte is still unclear. [2] One third of the lesions are multiple. [3] Multiple eruptive dermatofibromas have been reported, in patients with autoimmune diseases such as lupus erythematous and those on immunosuppressive drugs. [4],[5]

The course is benign with slow spontaneous involution. Less than 5% of dermatofibromas recur after excision. [6] Involution may occur after many years.

Carbon dioxide laser has benefits over other modalities in terms of absence or delay in recurrence due to influence on fibroblast secretion of growth factor. [7] In conclusion, we emphasize that dermatofibromas may clinically resemble neurofibromas or xanthomas, further multiple tumors can be effectively excised with carbon dioxide laser.

References
1.
Halpryn IH, Allen AC. Epidermal changes associated with sclerosing haemangiomas. Arch Dermatol 1959;80:160.
[Google Scholar]
2.
Bedi TR, Pandhi PK, Bhutani LK. Multiple palmoplantar histocytomas. Arch Dermatol 1976;122:1001-3.
[Google Scholar]
3.
Gonzalez S, Duarte I. Benign fibrous histiocytoma of the skin. A morphologic study of 290 cases. Pathol Res Pract 1982;174:379-91.
[Google Scholar]
4.
Kuniyuki S, Shindow K. Multiple dermatofibromas accompanied by eruptive benign keratosis in a patient with systemic lupus erythematosus. J Dermatol 1996;23:619-22.
[Google Scholar]
5.
Toda S, Heasley DD, Carlson JA, Mihm MC Jr. Lentiginous melanocytic hyperplasia overlying dermatofibroma. J Dermatol 1996;23:840-4.
[Google Scholar]
6.
Calonge E, Fletcher CD. Cutaneous fibrohistiocytic tumors: An update. Adv Anat Pathol 1994;1:2.
[Google Scholar]
7.
Nowak KC, McCorack M, Koch RJ. The effect of superpulsed carbon dioxide laser energy on keloid and normal dermal fibroblast secretion of growth factors. Plast Reconstr Surg 2000;105:2039-48.
[Google Scholar]

Fulltext Views
3,187

PDF downloads
533
Show Sections