Dermatofibromas are common, benign, asymptomatic-to-slightly itchy lesions occurring more frequently in females. They vary in number from 1 to 10 and can be found anywhere on the extremities and trunk, but they are most likely to occur on the anterior surface of the lower legs. Dermatofibromas may not be tumors; rather, they may represent a fibrous reaction to trauma, a viral infection, or an insect bite. They appear as 3- to 10-mm, slightly raised, pink-brown, sometimes scaly, hard growths that retract beneath the skin surface during attempts to compress and elevate them with the thumb and index finger (Figures 20-22 to 20-25 [22] [23] [24] [25]). Multiple dermatofibromas (i.e., more than 15) are very rare but have been reported with systemic lupus erythematosus,[20][21] with and without immunosuppressive therapy. Dermatoscopic examination shows a central white scarlike patch and a delicate pigment network at the periphery (see Figure 20-40 ).
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