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KMID : 0363220140520120924
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Korean Journal of Dermatology
2014 Volume.52 No. 12 p.924 ~ p.925
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Dermatofibroma on the Lip
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Jeon Woo-Seok
Lee Ji-Hyun
Kim Tae-Yoon
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Abstract
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Dermatofibroma (benign fibrous histiocytoma) can occur at various sites on the body surface with a predilection for the extremities1. However, involvement of the oral mucosa, especially of the lip, is very uncommon1. To our knowledge, only seven cases of dermatofibroma on the lip have been reported in the English literature (Table 1), and it has been rarely reported in the Korean literature2. Here, we report a case of a dermatofibroma on the upper lip. A 32-year-old woman presented with solitary nodule on the upper lip. She had an accidental lip biting injury 1 year previously. Several weeks after the minor trauma on the upper lip, she noticed an asymptomatic slow-growing solitary nodule at the bite site. Physical examination revealed a 7-mm, fixed rubbery nodule on the upper lip (Fig. 1A). The lesion was initially suspected as a mucocele or traumatic fibroma. Excisional biopsy was performed. Histologically, hyperplastic epidermis and a poorly circumscribed dermal tumor, which are separated by a Grenz zone from the epidermis, were observed (Fig. 1B). The tumor consisted of fibroblast-like spindle cells and histiocytes arranged in storiform pattern that intermingled with collagen fibers (Fig. 1C). Immunohistochemical staining for CD34, CD68, and factor XIIIa was performed. CD34 was negative in the fibroblastic spindle tumor cells and positive in vessels (Fig. 1D) CD68 was positive in the fibroblasts and histiocytes (Fig. 1E); and factor XIIIa was focally positive in the histiocytes (Fig. 1F). These findings were consistent with dermatofibroma. Dermatofibroma arising on the lip is very rare; therefore, it can preclude accurate clinical diagnosis. On the basis of this case, we suggest that dermatofibroma should be considered in the differential diagnosis of a nonulcerative nodule on the lip. One previously reported case was also associated with a history of trauma3. The pathogenesis of dermatofibroma has been controversial, as a reactive or inflammatory trigger by mechanical stimuli may contribute to its development4. Our case indicated the influence of a preceding traumatic episode, which tends to support the view that the disease arises from a reactive rather than a neoplastic process. However, it is still unclear whether dermatofibroma is a true neoplasm or a reactive hyperplasia. Simple excision is the definite treatment of dermatofibroma5; however, careful clinical follow-up is recommended because facial dermatofibroma has a high recurrence rate5.
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KEYWORD
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Dermatofibroma, Lip
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