Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(3):e2022102 1

Dermoscopy of Atrofic Dermatofibroma  
as a Rare Variant 

Tugba Kevser Ustunbas Uzuncakmak1, Bengu Cobanoglu Simsek2

1 Sisli Memorial Hospital, Department of Dermatology, Istanbul, Turkey

2 Istanbul Medeniyet University Medical Faculty, Department of Pathology, Istanbul, Turkey

Citation: Uzuncakmak TKU, Cobanoglu Simsek B. Dermoscopy of Atrofic dermatofibroma as a rare variant.  
Dermatol Pract Concept. 2022;12(3):e2022102. DOI: https://doi.org/10.5826/dpc.1203a102

Accepted: October 25, 2021; Published: July 2022

Copyright: ©2022 Uzuncakmak et al. This is an open-access article distributed under the terms of the Creative Commons  
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted 
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: Both authors have contributed significantly to this publication.

Corresponding author: Dr Tugba Kevser Ustunbas Uzuncakmak, MD, Sisli Memorial Hospital, Department of Dermatology, Istanbul, 
Turkey, Telephone: 0 +90- (530) 6640226 E-mail: drtugbakevser@gmail.com

Case Presentation 

A 12-year-old boy presented with a 1-year history of slowly 

growing, 1,5 cm x 2 cm, livedoid, hard and depressed livedoid 

lesion on his back (Figure 1, A and B). Dermoscopic evalu-

ation showed homogenous gray-whitish and livedoid large 

clods and crystalline structures (Figure 1C). The patient was 

referred for total excision. Histologically, fibro-histiocytic 

benign tumoral lesion located in a dense collagenized 

stroma separated from the epidermis by a cell-poor zone 

was observed. A few scattered lymphocytes were observed in  

between (Figure 1, D and E).

Teaching point

Atrophic dermatofibroma is a rare variant of dermato-

fibroma which was first described by Page and Assaad in 

1987 [1]. It is commonly seen on the upper back of mid-

dle-aged women, and the mean age of the patients affected 

is 49.7 years, according to literature [1]. We present this  

uncommon entity, which is in the differential diagnosis with 

many benign and malignant lesions including atrophic scars, 

anetodermas, morphea, atrophic dermatofibrosarcoma pro-

tuberans and sclerosing basal cell carcinomas, as it is rare in 

the pediatric age group [2].



2 Image Letter | Dermatol Pract Concept. 2022;12(3):e2022102

References

1. Ohnishi T, Sasaki M, Nakai K, Watanabe S. Atrophic dermatofi-

broma. J Eur Acad Dermatol Venereol. 2004;18(5):580-583. DOI: 

10.1111/j.1468-3083.2004.00975.x. PMID: 15324399.

2. Mota AN, Tortelly VD, Obadia DL, Silva RS. Atrophic der-

matofibroma. An Bras Dermatol. 2013;88(5):793-795. DOI: 

10.1590/abd1806-4841.20132234. PMID: 24173186. PMCID: 

PMC3798357.

Figure 1. (A and B) Clinical presentation of a 1,5 cm x 2 cm, hard and depressed livedoid lesion on the back. (C) Gray-whitish and livedoid 

large clods with a homogenous distribution seen at dermoscopy. (D and E) Correlated histological images: fibro-histiocytic benign tumoral 

lesion located in a dense collagenized stroma separated from the epidermis by a cell-poor zone (H&E, x100, x200).