Dermoscopic patterns of dermatofibroma in 72 Chinese patients

Have you ever noticed a small, firm bump on your skin that dimples when you press its sides? That’s a dermatofibroma—a common benign skin tumor made of fibrous and immune cells. While harmless, these lesions can look similar to more serious skin conditions, so accurate diagnosis is key. Enter dermoscopy: a non-invasive tool that uses magnification and light to reveal hidden patterns in the skin, helping doctors distinguish benign growths from dangerous ones.

A 2019 study published in the Chinese Medical Journal by researchers from the First Affiliated Hospital of Nanjing Medical University (Juliandri Juliandri, Xiao-Yan Wang, Zi-Jing Liu, Jia-Wen Zhang, and Yang Xu) set out to map the dermoscopic “faces” of dermatofibromas in 72 Chinese patients. The goal? To give doctors clearer guidelines for diagnosing these lesions without surgery—and to understand how skin type might shape what they see.

What the Study Did

The team analyzed 82 dermatofibromas (confirmed via surgical biopsy and tissue analysis) from patients aged 18 to 71 (median age 40). Each lesion was examined with a DermLite DL1 dermoscope (3 Gen Inc.) using polarized light—a standard method for visualizing skin structures. The researchers used criteria from a landmark 2008 study (by Zaballos et al.) to categorize dermoscopic patterns and statistical tests to check for links between patterns, age, gender, or where the lesion grew (limbs vs. trunk).

Key Findings

Who Gets Them: Women were 1.8 times more likely to have dermatofibromas (63.9% of patients) than men (36.1%).
Where They Grow: Most lesions appeared on the limbs (74.4%), like arms or legs, rather than the trunk (25.6%).
How They Look Clinically: Papules (small, raised bumps) were the most common type (51.2%).

Under the dermoscope, the most frequent pattern was a “peripheral delicate pigment network with central white network”—seen in 20.7% of lesions. This means the outer edge of the lesion had a fine, web-like pigment pattern, while the center showed a white, lattice-like network. Other common patterns included:

Multiple white scarlike patches (13.4%)
Total delicate pigment network (13.4%) (the entire lesion had that fine web pattern)
Total homogeneous area (11.0%) (a smooth, uniform color without distinct patterns)

Crucially, the team found no significant links between dermoscopic patterns and age, gender, or lesion location. That means these patterns are consistent whether you’re 20 or 70, male or female, or have a lesion on your arm or back.

Why This Matters for Diagnosis

The study’s top pattern—peripheral pigment network with central white network—aligns with Fitzpatrick skin phototype III, which is common in East Asian populations. For comparison, darker-skinned patients (e.g., Fitzpatrick IV-VI) often show “pigmented rings around hair follicles” (a pattern identified in a 2017 study by Kelati et al.). These differences matter because dermoscopy relies on recognizing patterns that fit a patient’s skin type. For Chinese patients, knowing that “peripheral pigment + central white network” is a red flag for dermatofibroma can help doctors avoid unnecessary biopsies and ease patient anxiety.

The Bottom Line

Dermatofibromas are harmless, but their similarity to more serious lesions (like melanoma) means accurate diagnosis is critical. This study adds vital data to the global dermoscopy toolkit—especially for doctors treating East Asian patients. By understanding these patterns, clinicians can diagnose dermatofibromas faster, more confidently, and without cutting into the skin.

The original study was published in the Chinese Medical Journal in 2019. For more details, you can access the full paper via doi.org/10.1097/CM9.0000000000000406

Was this helpful?

0 / 0