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Pathology

1. Dermatofibroma
   • AKA fibrous histiocytoma: benign neoplasm of dermal fibroblasts
   • ?Result of an abortive immunoreactive process featuring dermal dendritic cells as initaitors of disease

Approach

• Examine as for any lump

1. Inspect
   • Occur anywhere but common on lowerslimbs of young to middle-aged women
   • Small pink / brown pigmented hemispherical nodules
   • Smooth in appearance
2. Palpation
   • Firm "woody" feel
   • Part of skin and are fully mobile over deep tissues

Completion

1. Symptoms from the lump

Differential diagnosis

1. Malignant tumours
   1. Malignant melanoma
   2. Basal cell carcinoma
2. Non-malignant tumours

Treatment

1. Non-surgical
   • Leave alone if asymptomatic and patient does not want intervention
2. Surgical
   • Simple excision followed by histological examination