Treating A Pigmented, Slightly Pruritic Nodule

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By G. “Dock” Dockery, DPM, FACFAS

Injections with intralesional corticosteroids may decrease the size and color of lesions. In many cases, the steroid will make them softer. Steroid injections are not considered to be highly successful and have some potential complications of atrophy, discoloration and/or telangiectasia. Some physicians have stopped recommending this approach. Cryosurgery is also useful in flattening and decreasing the color of lesions. This approach does not have the potential side effects of steroid injections.

Since dermatofibromas are deep lesions with widened bases, simple excision of the lesion may result in unsightly, thick and dark scars. Recurrences are common. Wide excision of the lesion and complete removal of the deep portions of the mass are necessary to prevent return of the lesion. One may subsequently close the resultant defect with a variety of reciprocal flaps used for closing circular defects or with a single-lobed flap. One should submit all removed specimens for dermatopathology confirmation of the diagnosis of dermatofibroma.


Suggested Reading
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