Atypical dermatofibroma simulating hansenoma
Introduction: dermatofibroma is a benign mesenchymal lesion of uncertain etiology, centered in the dermis, with fibroblastic and histiocytic differentiation. The atypical variant can mimic superficial sarcoma histologically.
Objective: to describe the clinical and histopathological findings of atypical dermatofibroma in a patient undergoing treatment for leprosy with multiple therapeutic failures.
Case Description: the report concerns a 39-year-old woman with multiple therapeutic failures for Virchowian leprosy, who developed an atypical dermatofibroma on the upper limb, which clinically resembled a leproma.
Discussion: molecular analyses suggest dermatofibroma may be associated with a neoplastic process. However, several studies correlate it to trauma, insect bites, folliculitis, immunological changes, and treated or reactive leprosy. The association of dermatofibroma and leprosy, especially in the Virchowian pole, is documented in the literature. However, there are no reports of atypical dermatofibroma associated with leprosy.
Final Considerations: this case adds to other studies regarding a possible association between the pathogenesis of dermatofibroma and the immunological aspects present in leprosy.
English abstract:
Introduction: dermatofibroma is a benign mesenchymal lesion of uncertain etiology, centered in the dermis, with fibroblastic and histiocytic differentiation. The atypical variant can mimic superficial sarcoma histologically.
Objective: to describe the clinical and histopathological findings of atypical dermatofibroma in a patient undergoing treatment for leprosy with multiple therapeutic failures.
Case Description: the report concerns a 39-year-old woman with multiple therapeutic failures for Virchowian leprosy, who developed an atypical dermatofibroma on the upper limb, which clinically resembled a leproma.
Discussion: molecular analyses suggest dermatofibroma may be associated with a neoplastic process. However, several studies correlate it to trauma, insect bites, folliculitis, immunological changes, and treated or reactive leprosy. The association of dermatofibroma and leprosy, especially in the Virchowian pole, is documented in the literature. However, there are no reports of atypical dermatofibroma associated with leprosy.
Final Considerations: this case adds to other studies regarding a possible association between the pathogenesis of dermatofibroma and the immunological aspects present in leprosy.
Spanish abstract:
Introducción: el dermatofibroma es una lesión mesenquimal benigna, de etiología incierta, centrada en la dermis, con diferenciación fibroblástica e histiocítica. La variante atípica puede simular un sarcoma superficial en la histología.
Objetivo: describir los hallazgos clínicos e histopatológicos de un dermatofibroma atípico que surge en una paciente en tratamiento para lepra, con múltiples fracasos terapéuticos.
Descripción del caso: el informe trata sobre una mujer de 39 años, con múltiples fracasos terapéuticos para la lepra virchowiana, que desarrolló un dermatofibroma atípico en el miembro superior, el cual clínicamente simulaba un leproma.
Discusión: los análisis moleculares sugieren que el dermatofibroma podría estar asociado a un proceso neoplásico. Sin embargo, varios estudios lo asocian a traumas, picaduras de insectos, foliculitis, alteraciones inmunológicas y lepra tratada o reactiva. La asociación entre dermatofibroma y lepra, especialmente en el polo virchowiano, está documentada en la literatura. No obstante, no existen reportes de dermatofibroma atípico asociado con lepra.
Consideraciones finales: este caso se suma a otros estudios en relación con una posible asociación de la patogénesis del dermatofibroma con aspectos inmunológicos presentes en la lepra.