Multiple Eruptive Dermatofibroma: A Case Report

Background

Multiple eruptive dermatofibroma (MEDF) is a rare presentation of dermatofibroma which is frequently associated with underlying diseases such as human immunodeficiency virus infection or systemic lupus erythematosus. It generally presents a characteristic histology with hyperplasia of the epidermis, prominent bundles of collagen and a diffuse proliferation of fibrocytes.

Case Summary

We report a case of MEDF in a 30-year-old man who presented with a large number of dark brownish red maculopapules distributed over the trunk and extremities for more than 10 years. According to the pathology, the patient was diagnosed with MEDF. Infections and autoimmune diseases were ruled out. As he had no clinical symptoms, and presented with lesions widely distributed over the body, we gave no special treatment, but suggested a regular examination.

Conclusion

Patients with MEDF usually have no pain and pruritus. If human immunodeficiency virus infection and systemic lupus erythematosus and other causes are ruled out, and lesions are widely distributed over the body, regular check-up is recommended without specific treatment.

Multiple dermatofibromas, associated clinical and histological characteristics: A systematic review

Multiple dermatofibromas (DFs) are rare benign fibrohistiocytic lesions characterized by asymptomatic hyperpigmented nodules. Several diseases, like systemic lupus erythematosus (SLE) and human immunodeficiency virus (HIV) infection, are found to be associated with multiple DFs. Here, we designed a systematic review by an electronic search of PubMed and Embase databases to select case reports of multiple DFs (29 May 2021). From 2,145 initially found articles, 96 studies (106 cases) were included. We classified multiple DFs (>1 DF lesion) into four subtypes and separately investigated clinical characteristics of each one: multiple eruptive DFs (MEDFs) (n = 45), multiple (n = 41), multiple clustered DFs (MCDFs) (n = 18), and giant combined (n = 2). The patients' mean age was 38.3 ± 14.7 years. The majority were female (61.3 %). The lesions were commonly on the trunk and extremities (36.8 %). MEDFs (n = 36) had the most rapid disease onset (2.0 ± 6.6 years). Immunosuppression induced by either HIV (10.3 %) and hematologic malignancy (9.4 %) or immunosuppressive drugs (23.4 %) along with SLE (19.8 %) were the most observed associations. However, 66.7 % of the MCDF patients were otherwise healthy individuals. As for disease management, surgery and follow-up were the preferred options. Most of the cases showed neither resolution nor development of new lesions in follow-up.