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December 09, 2016 00:05

Dermatofibroma .Causes.Symptoms .Diagnostics.Treatment

Dermatofibroma (sin.: histiocytoma, angiofibroksantoma, sclerosing hemangioma, fibroksantoma, and nodular subepidermal fibrosis) - a benign tumor of connective tissue in the form of a slowly growing painless node, single, rarely multiple nodular or blyashkovidnoe formation of a diameter of about 1 cm, slightly toweringin the center.

causes and pathogenesis dermatofibromas not been studied.

Symptoms dermatofibromas.In most cases, the disease occurs in women.It appears rounded tumor formation, deep foundation in the skin.The tumor is a single or multiple mobile node.The tumor has a small amount (from 3.2 mm to 1.0-1.5 cm), thick consistency and dark brown in color and acts as a hemisphere above the skin surface.Also, the tumor can be, as it is welded, drawn into the skin so that the upper pole ee is flush with the skin surface.Subjective feelings are absent.

palpation dense, easily mixed, the surface is smooth, sometimes giperkeraticheskaya, verrucous.Color cup a reddish-brown, more intense in the old

cell.There is a bowl at the young wives of tires, mostly on the lower extremities.Multiple small disseminated dermatofibromas can be combined with osteopoikilosis {syndrome Buschke -Ollendorfa)

Histopathology.Histologically marked accumulation arranged in different directions and young mature collagenous fibers.fibroblasts, histiocytes and abundance of small capillaries with swollen endothelium.Seldom multi Tutona cells.

Pathology.A large number of synonymous dermatofibromas indicates significant variability histology.In this regard, some authors identify options dermatofibromas in separate disease entities.This applies primarily to such options as angiofibroksantoma and histiocytoma.In our opinion, it is appropriate to consider these tumor variants dermatofibromas because their morphological features and histogenesis are similar.They are characterized by a predominance of one or another component and the degree of maturity.

constituent elements of any option dermatofibromas cells are fibroblastic series, fibrous substance and vessels.Depending on the prevalence of the composite component can distinguish between the cellular and fibrous tumor types.

Fibrous type is characterized by a predominance of mature and young collagen fibers, which are located in different directions, sometimes in the form of a swirling beams and moiré patterns.Land young collagen stained with hematoxylin and eosin in a pale blue color, fibers are arranged separately and not in the form of bundles.Cells mostly mature form (fibroblasts), but may be shaped and young - fibroblasts.The tumor sometimes sharply demarcated from the surrounding dermis, sometimes its border vague.

dermatofibroma cell type characterized by the presence of large amounts of cellular elements, generally fnbroblastov surrounded by small amounts of collagen fibers.Among the fibroblasts are located, sometimes in the form of nests, histiocytes.They are bigger fibroblast nucleus of the oval, in the cytoplasm contains a considerable amount of lipid and hemosiderin.In some tumors histiocytes predominate among which are located (sometimes in large quantities) Tutona cells.These large cells with multiple nuclei, sometimes sruppirovannoye in massive cytoplasm.Peripheral sections of the cytoplasm of these cells contain dvoyakoprelomlyayushiesya lipids, sometimes you can see the typical foam cells.In some cases, the last prevail, lying in a nest among the fibroblastic elements, in connection with which such an option is called dermatofibromas fibroksantomoy.Strom cellular slime fibroma consists of delicate, loosely arranged collagen fibers, sometimes with the presence of rhythmic structures.

In all cases dermatofibromas find vessels of various calibers with swollen endothelial cells.In some cases, among the cellular elements, and fibrous structures are found in a large number of capillary blood vessels, which gives rise to some authors call such a tumor skleroziruyushey hemangioma.Sometimes along with vessels of capillary type nablkdayutsya larger vessels with dramatically enhanced lumen, having a form of slots, which are located in the connective tissue, where collagen fibers form characteristic moiré patterns.The fibroblastic cells exhibit dvoyakoprelomlyayushie lipids (angiofibroksantoma classification LK Apatenko).

Histogenesis.All histological dermatofibromas varieties described above have a common histogenesis.Noted.fibroblastic elements that have tumor potency of phagocytosis, however they often contain lipids and iron.Scientists have identified the activity of acid phosphatase in all types dermatofibroma fibroblasts.This is confirmed by electron microscopy.So, S. G. Carrington and R.K.Winkelmann (1972).dermatofibromu studying with lots of lipid and hemosiderin showed that the phagocytic cells have all the signs of fibroblast: oval nuclei, extended eidoplazmaticheskuyu network and perinuclear location of the fibrillar structures.

differential diagnosis.Differentiate dermatofibromu follows from lipoma, nevus pigment.

Treatment dermatofibromas.Perform surgery (electroexcision) excision.The center can be administered corticosteroids.