What is Dermatofibroma?
A dermatofibroma is a benign nodule under the skin caused by overgrowing fibrous tissue in the skin. It can feel firm and may be tender. Its colour can range from pink to brown, but it may change over time. When pinched, a dimple in the skin should appear over the lesion. Shaving over the lesion can cause it to bleed. They seldom grow more than 1cm across, and are typically found on the extremities such as the lower legs. They usually develop during young adulthood, and are found more often in women than men. Sometimes they seem to occur after a minor injury to the skin such as a bug bite. Some people with autoimmune diseases may develop more than one dermatofibroma at a time.
What are the signs and symptoms?
Dermatofibromas appear as a firm bump under the skin. They move with the skin and can be tender. Their colour can range from pink to brown, and they can have a smooth and shiny to scaly surface. When pinched, you should be able to see a dimple in the skin just over the lesion.
What kind of tests can I undergo?
A doctor can usually identify a dermatofibroma just by visual inspection. A physical exam may be needed, or a referral to a dermatologist. Surgical excision of the entire lesion may help to confirm the diagnosis and to eliminate any fears of malignancy. You should consult your doctor anytime you find a bump on your body, as many symptoms can be similar to that of skin cancer.
What are the treatment options?
Usually, no immediate treatment is necessary for dermatofibromas. If it is not malignant, it would not be harmful to one’s health to leave it as it is. However, many people with dermatofibromas do tend to seek treatment, especially since the lesion can continually grow. This is usually for cosmetic reasons. Treatment might also be sought if the lesion is itchy and painful, or if there is uncertainty about the diagnosis. Dermatofibromas can also suddenly go away, but they can also last forever. Steroid injections and freezing of the lesion are options to treat it, but surgical excision leaves the lowest chance of the lesion recurring.
What can I expect from surgery?
The surgical procedure to remove a dermatofibroma is quite easy. The surgery itself would typically take approximately 15 minutes. Local freezing would be used, and about 20-30 minutes would be added to the surgery time to allow for the freezing to set in. However, because of the local freezing, the patient would be fit to drive home afterwards. Once the specimen has been excised, it will be sent to a lab to be tested for any malignancy and to confirm the diagnosis. Stitches will be needed, and will typically be removed 5-14 days later, depending on the size and location of surgery. Redness is normal even after the stitches have been taken out, but after 4-6 months the scar should be hardly visible. There should be minimal to no pain after the local freezing has worn off, but Tylenol Extra Strength can be taken if there is.
What are the risks?
The risks of excising a dermatofibroma are very rare but can include infection, suture reactions, bleeding, bruising, and scarring. Please speak to your doctor about any medications you are taking and if you have had abnormal scarring (keloids or hypertrophic scars) in the past.
How much will it cost?
Unfortunately, the surgery to remove a dermatofibroma is not covered by OHIP. A consultation with Dr. Hong is recommended to find out the exact price for your procedure. Without a referral from your family doctor, an $95 consultation fee will be required, but it will be applied towards the cost of the surgery. There is no additional fee for follow up appointments such as the removal of sutures.
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