CPC Case of the Month

LINEAR DERMATOFIBROMA WITH SATELLITOSIS

Submitted by: Bruce Ragsdale, MD, San Luis Obispo, CA and Robert Carson, MD, Oxnard, CA

CLINICAL A 56-year-old male sustained a high school wrestling injury at 16 or 17 years of age. The lower leg, just above the ankle, was taped. As a joke, someone ripped the tape off. Thereafter the area turned red. Within months it grew to the present size of the lesion, which has darkened over the years. In the first year of college he was advised the area would go away. It has persisted without itch, peel, pain, or regression.
HISTOLOGY Angular fibroblasts between thickened collagen bundles beneath epidermal hyperplasia characterize this benign lesion, which does not involve subcutaneous fat shown on the slide. Basaloid buds are induced along the hyperplastic epidermis which in some ways resemble seborrheic keratosis.
IMPORTANT FEATURE: REASON FOR PRESENTATION A serpiginous bandlike configuration is a strange configuration for a dermatofibroma.
REFERENCES 1. Han KH, Huh CH, Cho KH. Proliferation and differentiation of the keratinocytes in hyperplastic epidermis overlyind dermatofibroma: immunohistochemical characterization. Am J Dermatopathol 2001;23:90-98. 2. Morgan MB, Howard H G, Everett MA. Epithelial induction in dermatofibroma: a role for the epidermal growth factor (EGF) receptor. Am J Dermatopathol 1997;19:35-40. 3. Curco N et al. Dermatofibroma with spreading satellitosis. J Am Acad Dermatol 1192;27:1017-1019.