Dermatofibroma pathophysiology: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(38 intermediate revisions by 8 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Dermatofibroma}}
{{Dermatofibroma}}
{{CMG}};{{AE}}{{SM}}
{{CMG}}, {{AE}}{{Homa}}{{Faizan}}


Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]] to learn about editing.
==Overview==
The exact pathogenesis of dermatofibroma is not fully understood. Although some mechanisms are suggested in the [[pathogenesis]] of this disease that include, reactive [[tissue]] changes, [[neoplastic]] [[proliferation]], the cell surface [[proteoglycan]], [[Syndecan 1|syndecan-1]], and [[fibroblast growth factor receptor 2]] may play a role in the [[growth]] of dermatofibromas, [[Transforming growth factor-β|transforming growth factor-beta]] ([[TGF-beta]]) [[Signaling pathway|signaling]] may be involved in the [[development]] of [[fibrosis]] in [[dermatofibroma]], and the presence of [[Factor XIII|factor XIIIa]] and [[CD]]168 suggests that dermatofibroma can originate from the [[dermal]] [[dendritic cell]]. On [[gross pathology]], firm yellowish [[papules]] which may have areas of [[hemorrhage]] and lipidization are characteristic findings of dermatofibroma. Microscopically dermatofibroma is characterized by localized [[nodular]] [[proliferation]] of [[spindle]]-shaped [[fibrous]] [[Cells (biology)|cells]] in a [[mixture]] of [[Histiocyte|histocytoid]] [[Cells (biology)|cells]] inside the [[dermis]], spiculated margin of cells, “Storiform” [[pattern]] which defines as whorls of elongated [[nuclei]], [[collagen]] bundles that usually seen inside and between the [[fascicles]] of [[Spindle|spindled]] [[fibrous]] [[cells]], "Grenz zone" which is an unaffected layer that separates the overlying [[epidermis]] from the [[dermis]], and [[epidermal]] [[hyperplasia]].


==Pathophysiology==
==Pathophysiology==
* Some physicians and researchers believe dermatofibromas form as a reaction to previous injuries such as insect bites or thorn pricks.
===Pathogenesis===
* Dermatofibromas are composed of disordered [[collagen]] laid down by [[fibroblasts]].
*The exact [[pathogenesis]] of dermatofibroma is not completely understood.


===Immunohistochemical staining===
*The mechanisms which are suggested in the [[pathogenesis]] of dermatofibroma include:<ref name="pmid10660130">{{cite journal| author=Chen TC, Kuo T, Chan HL| title=Dermatofibroma is a clonal proliferative disease. | journal=J Cutan Pathol | year= 2000 | volume= 27 | issue= 1 | pages= 36-9 | pmid=10660130 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10660130  }} </ref><ref name="pmid14501288">{{cite journal| author=Sellheyer K, Smoller BR| title=Dermatofibroma: upregulation of syndecan-1 expression in mesenchymal tissue. | journal=Am J Dermatopathol | year= 2003 | volume= 25 | issue= 5 | pages= 392-8 | pmid=14501288 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14501288 }} </ref><ref name="SkrozaRotolo2008">{{cite journal|last1=Skroza|first1=Nevena|last2=Rotolo|first2=Sabrina|last3=Ceccarelli|first3=Simona|last4=Romano|first4=Ferdinando|last5=Innocenzi|first5=Daniele|last6=Frati|first6=Luigi|last7=Angeloni|first7=Antonio|last8=Marchese|first8=Cinzia|title=Modulation of the expression of the FGFR2-IIIb and FGFR2-IIIc molecules in dermatofibroma|journal=Journal of Dermatological Science|volume=51|issue=1|year=2008|pages=53–57|issn=09231811|doi=10.1016/j.jdermsci.2008.02.004}}</ref><ref name="KuboIhn2006">{{cite journal|last1=Kubo|first1=M.|last2=Ihn|first2=H.|last3=Yamane|first3=K.|last4=Tamaki|first4=K.|title=The expression levels and the differential expression of transforming growth factor-beta receptors in dermatofibroma and dermatofibrosarcoma protuberans|journal=British Journal of Dermatology|volume=154|issue=5|year=2006|pages=919–925|issn=0007-0963|doi=10.1111/j.1365-2133.2005.06904.x}}</ref><ref name="CerioSpaull2006">{{cite journal|last1=Cerio|first1=R.|last2=Spaull|first2=J.|last3=Jones|first3=E.Wilson|title=Histiocytoma cutis: a tumour of dermal dendrocytes (dermal dendrocytoma)|journal=British Journal of Dermatology|volume=120|issue=2|year=2006|pages=197–206|issn=00070963|doi=10.1111/j.1365-2133.1989.tb07783.x}}</ref><ref name="TörőcsikBárdos2005">{{cite journal|last1=Törőcsik|first1=D.|last2=Bárdos|first2=H.|last3=Nagy|first3=L.|last4=Ádány|first4=R.|title=Identification of factor XIII-A as a marker of alternative macrophage activation|journal=Cellular and Molecular Life Sciences|volume=62|issue=18|year=2005|pages=2132–2139|issn=1420-682X|doi=10.1007/s00018-005-5242-9}}</ref><ref name="pmid1972317">{{cite journal| author=Cerio R, Spaull J, Oliver GF, Jones WE| title=A study of factor XIIIa and MAC 387 immunolabeling in normal and pathological skin. | journal=Am J Dermatopathol | year= 1990 | volume= 12 | issue= 3 | pages= 221-33 | pmid=1972317 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1972317 }} </ref>
{| class="wikitable" border="1"
**Reactive [[tissue]] changes
|-
**[[Neoplastic]] [[proliferation]] because of the [[clonality]]
! Neoplasm
**The cell surface [[proteoglycan]], [[Syndecan 1|syndecan-1]], and [[fibroblast growth factor receptor 2]] may play a role in the [[growth]] of dermatofibromas.
!  [[CD34]]
**[[Transforming growth factor-β|Transforming growth factor-beta]] ([[TGF-beta]]) [[Signaling pathway|signaling]] may be involved in the [[development]] of [[fibrosis]] in [[dermatofibroma]]
!  [[Stromelysin-3]]<ref>{{cite journal | pmid = 17596171 | doi=10.1111/j.1365-2133.2007.08033.x | volume=157 | issue=2 | title=Stromelysin-3 expression in the differential diagnosis of dermatofibroma and dermatofibrosarcoma protuberans: comparison with factor XIIIa and CD34 | year=2007 | month=August | author=Kim HJ, Lee JY, Kim SH, ''et al.'' | journal=Br. J. Dermatol. | pages=319–24}}</ref>
**The presence of [[Factor XIII|factor XIIIa]] and [[CD]]168 suggests that dermatofibroma can originate from the [[dermal]] [[dendritic cell]].
!  [[Factor XIIIa]]<ref>http://emedicine.medscape.com/article/1056742-overview</ref>
|-
| Dermatofibroma
| +
| +
| +
|-
|  [[Dermatofibrosarcoma protuberans]]
|  +
| -
| -  
|}


==Genetics==


===Video===
*There is no [[genetic]] alteration involved with [[pathogenesis]] of dermatofibroma.
{{#ev:youtube|tq4xFLIw1TA}}
 
==Associated Conditions==
[[Conditions]] associated with multiple dermatofibromas include:<ref name="BhattacharjeeUmar2005">{{cite journal|last1=Bhattacharjee|first1=Pradip|last2=Umar|first2=Saleem|last3=Fatteh|first3=Shokat|title=Multiple Eruptive Dermatofibromas Occurring in a Patient with Myelodysplastic Syndrome|journal=Acta Dermato-Venereologica|volume=-1|issue=1|year=2005|pages=1–1|issn=0001-5555|doi=10.1080/00015550410024517}}</ref><ref>{{Cite journal
| author = [[I. Lu]], [[P. R. Cohen]] & [[M. E. Grossman]]
| title = Multiple dermatofibromas in a woman with HIV infection and systemic lupus erythematosus
| journal = [[Journal of the American Academy of Dermatology]]
| volume = 32
| issue = 5 Pt 2
| pages = 901–903
| year = 1995
| doi = 10.1016/0190-9622(95)91558-3
| pmid = 7722054
}}</ref><ref>{{Cite journal
| author = [[P. R. Cohen]]
| title = Multiple dermatofibromas in patients with autoimmune disorders receiving immunosuppressive therapy
| journal = [[International journal of dermatology]]
| volume = 30
| issue = 4
| pages = 266–270
| year = 1991
| pmid = 2050454
}}</ref><ref>{{Cite journal
| author = [[Mayuri Tanaka]], [[Toshihiko Hoashi]], [[Naotaka Serizawa]], [[Kyochika Okabe]], [[Susumu Ichiyama]], [[Rie Shinohara]], [[Yoko Funasaka]] & [[Hidehisa Saeki]]
| title = Multiple unilaterally localized dermatofibromas in a patient with Down syndrome
| journal = [[The Journal of dermatology]]
| volume = 44
| issue = 9
| pages = 1074–1076
| year = 2017
| doi = 10.1111/1346-8138.13625
| pmid = 27665731
}}</ref><ref>{{Cite journal
| author = [[J. Stainforth]] & [[M. J. Goodfield]]
| title = Multiple dermatofibromata developing during pregnancy
| journal = [[Clinical and experimental dermatology]]
| volume = 19
| issue = 1
| pages = 59–60
| year = 1994
| pmid = 8313640
}}</ref><ref>{{Cite journal
| author = [[Yuichiro Tsunemi]], [[Hironobu Ihn]], [[Naoko Hattori]], [[Hidehisa Saeki]] & [[Kunihiko Tamaki]]
| title = Multiple eruptive dermatofibromas with CD34+ cells in a patient with hypertriglyceridemia
| journal = [[Dermatology (Basel, Switzerland)]]
| volume = 207
| issue = 3
| pages = 319–321
| year = 2003
| doi = 10.1159/000073098
| pmid = 14571078
}}</ref><ref>{{Cite journal
| author = [[H. B. Bargman]] & [[I. Fefferman]]
| title = Multiple dermatofibromas in a patient with myasthenia gravis treated with prednisone and cyclophosphamide
| journal = [[Journal of the American Academy of Dermatology]]
| volume = 14
| issue = 2 Pt 2
| pages = 351–352
| year = 1986
| doi = 10.1016/s0190-9622(86)70041-8
| pmid = 3950136
}}</ref><ref>{{Cite journal
| author = [[S. E. Chang]], [[J. H. Choi]], [[K. J. Sung]], [[K. C. Moon]] & [[J. K. Koh]]
| title = Multiple eruptive dermatofibromas occurring in a patient with acute myeloid leukaemia
| journal = [[The British journal of dermatology]]
| volume = 142
| issue = 5
| pages = 1062–1063
| year = 2000
| doi = 10.1046/j.1365-2133.2000.03508.x
| pmid = 10809884
}}</ref>
 
*[[Pregnancy]]
*[[Chromosomal]] alterations ([[Down syndrome]])
*[[Metabolic disorders]] ([[hypertriglyceridemia]])
*[[Hematologic]] [[malignancies]]
*[[Immunodeficiency|Immunodeficient]] [[Disease|diseases]] ([[HIV]])
*[[Autoimmune diseases]] ([[myasthenia gravis]], [[pemphigus vulgaris]], and [[systemic lupus erythematosus]])
 
==Gross Pathology==
On [[gross pathology]], firm yellowish [[papules]] which may have areas of [[hemorrhage]] and lipidization are characteristic findings of dermatofibroma.<ref>{{cite book | last = LeBoit | first = P. E. | title = Pathology and genetics of skin tumours | publisher = IARC Press | location = Lyon | year = 2006 | isbn = 9283224140 }}</ref>
 
==Microscopic Pathology==
Microscopically dermatofibroma is characterized by: <ref name="LeeLee2015">{{cite journal|last1=Lee|first1=MiWoo|last2=Lee|first2=WooJin|last3=Jung|first3=JoonMin|last4=Won|first4=ChongHyun|last5=Chang|first5=SungEun|last6=Choi|first6=JeeHo|last7=Moon|first7=KeeChan|title=Clinical and histological patterns of dermatofibroma without gross skin surface change: A comparative study with conventional dermatofibroma|journal=Indian Journal of Dermatology, Venereology, and Leprology|volume=81|issue=3|year=2015|pages=263|issn=0378-6323|doi=10.4103/0378-6323.154795}}</ref><ref name="MentzelWiesner2012">{{cite journal|last1=Mentzel|first1=Thomas|last2=Wiesner|first2=Thomas|last3=Cerroni|first3=Lorenzo|last4=Hantschke|first4=Markus|last5=Kutzner|first5=Heinz|last6=Rütten|first6=Arno|last7=Häberle|first7=Michael|last8=Bisceglia|first8=Michele|last9=Chibon|first9=Frederic|last10=Coindre|first10=Jean-Michel|title=Malignant dermatofibroma: clinicopathological, immunohistochemical, and molecular analysis of seven cases|journal=Modern Pathology|volume=26|issue=2|year=2012|pages=256–267|issn=0893-3952|doi=10.1038/modpathol.2012.157}}</ref><ref name="Victor2003">{{cite journal|last1=Victor|first1=Thomas A.|title=Neoplasms With Follicular Differentiation, 2nd ed. A. BERNARD ACKERMAN, VIJAYA B. REDDY, AND H. PETER SOYER, eds.|journal=Dermatologic Surgery|volume=29|issue=6|year=2003|pages=641–641|issn=1076-0512|doi=10.1046/j.1524-4725.2003.29153.x}}</ref>
* Localized [[nodular]] [[proliferation]] of [[spindle]]-shaped [[fibrous]] [[Cells (biology)|cells]] in a [[mixture]] of [[Histiocyte|histocytoid]] [[Cells (biology)|cells]] inside the [[dermis]]
* Spiculated margin of cells
* “Storiform” [[pattern]] which defines as whorls of elongated [[nuclei]]
*[[Collagen]] bundles that usually seen inside and between the [[fascicles]] of [[Spindle|spindled]] [[fibrous]] [[cells]]
* "Grenz zone" which is an unaffected layer that separates the overlying [[epidermis]] from the [[dermis]]
*[[Epidermal]] [[hyperplasia]]
[[File:Proliferating histiocytic cells with foamy, granular cytoplasm.png|350px|thumb|https://openi.nlm.nih.gov/detailedresult?img=PMC3213176_1746-160X-7-20-3&query=&req=4|center]]
[[File:Spindle-shaped fibroblasts, arranged in a storiform pattern.png|350px|thumb|https://openi.nlm.nih.gov/detailedresult?img=PMC3213176_1746-160X-7-20-3&query=&req=4|center]]


==References==
==References==
{{Reflist|2}}


{{Reflist|2}}
[[Category:Medicine]]
[[Category:Needs overview]]
[[Category:Oncology]]
[[Category:Needs content]]
[[Category:Up-To-Date]]
[[Category:Dermatology]]
[[Category:Dermatology]]
[[Category:Disease]]
[[Category:Oncology]]

Latest revision as of 21:18, 29 July 2020

Dermatofibroma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Dermatofibroma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Dermatofibroma pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Dermatofibroma pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Dermatofibroma pathophysiology

CDC on Dermatofibroma pathophysiology

Dermatofibroma pathophysiology in the news

Blogs on Dermatofibroma pathophysiology

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Dermatofibroma pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2]Faizan Sheraz, M.D. [3]

Overview

The exact pathogenesis of dermatofibroma is not fully understood. Although some mechanisms are suggested in the pathogenesis of this disease that include, reactive tissue changes, neoplastic proliferation, the cell surface proteoglycan, syndecan-1, and fibroblast growth factor receptor 2 may play a role in the growth of dermatofibromas, transforming growth factor-beta (TGF-beta) signaling may be involved in the development of fibrosis in dermatofibroma, and the presence of factor XIIIa and CD168 suggests that dermatofibroma can originate from the dermal dendritic cell. On gross pathology, firm yellowish papules which may have areas of hemorrhage and lipidization are characteristic findings of dermatofibroma. Microscopically dermatofibroma is characterized by localized nodular proliferation of spindle-shaped fibrous cells in a mixture of histocytoid cells inside the dermis, spiculated margin of cells, “Storiform” pattern which defines as whorls of elongated nuclei, collagen bundles that usually seen inside and between the fascicles of spindled fibrous cells, "Grenz zone" which is an unaffected layer that separates the overlying epidermis from the dermis, and epidermal hyperplasia.

Pathophysiology

Pathogenesis

  • The exact pathogenesis of dermatofibroma is not completely understood.

Genetics

Associated Conditions

Conditions associated with multiple dermatofibromas include:[8][9][10][11][12][13][14][15]

Gross Pathology

On gross pathology, firm yellowish papules which may have areas of hemorrhage and lipidization are characteristic findings of dermatofibroma.[16]

Microscopic Pathology

Microscopically dermatofibroma is characterized by: [17][18][19]

https://openi.nlm.nih.gov/detailedresult?img=PMC3213176_1746-160X-7-20-3&query=&req=4
https://openi.nlm.nih.gov/detailedresult?img=PMC3213176_1746-160X-7-20-3&query=&req=4

References

  1. ↑ Chen TC, Kuo T, Chan HL (2000). "Dermatofibroma is a clonal proliferative disease". J Cutan Pathol. 27 (1): 36–9. PMID 10660130.
  2. ↑ Sellheyer K, Smoller BR (2003). "Dermatofibroma: upregulation of syndecan-1 expression in mesenchymal tissue". Am J Dermatopathol. 25 (5): 392–8. PMID 14501288.
  3. ↑ Skroza, Nevena; Rotolo, Sabrina; Ceccarelli, Simona; Romano, Ferdinando; Innocenzi, Daniele; Frati, Luigi; Angeloni, Antonio; Marchese, Cinzia (2008). "Modulation of the expression of the FGFR2-IIIb and FGFR2-IIIc molecules in dermatofibroma". Journal of Dermatological Science. 51 (1): 53–57. doi:10.1016/j.jdermsci.2008.02.004. ISSN 0923-1811.
  4. ↑ Kubo, M.; Ihn, H.; Yamane, K.; Tamaki, K. (2006). "The expression levels and the differential expression of transforming growth factor-beta receptors in dermatofibroma and dermatofibrosarcoma protuberans". British Journal of Dermatology. 154 (5): 919–925. doi:10.1111/j.1365-2133.2005.06904.x. ISSN 0007-0963.
  5. ↑ Cerio, R.; Spaull, J.; Jones, E.Wilson (2006). "Histiocytoma cutis: a tumour of dermal dendrocytes (dermal dendrocytoma)". British Journal of Dermatology. 120 (2): 197–206. doi:10.1111/j.1365-2133.1989.tb07783.x. ISSN 0007-0963.
  6. ↑ Törőcsik, D.; Bárdos, H.; Nagy, L.; Ádány, R. (2005). "Identification of factor XIII-A as a marker of alternative macrophage activation". Cellular and Molecular Life Sciences. 62 (18): 2132–2139. doi:10.1007/s00018-005-5242-9. ISSN 1420-682X.
  7. ↑ Cerio R, Spaull J, Oliver GF, Jones WE (1990). "A study of factor XIIIa and MAC 387 immunolabeling in normal and pathological skin". Am J Dermatopathol. 12 (3): 221–33. PMID 1972317.
  8. ↑ Bhattacharjee, Pradip; Umar, Saleem; Fatteh, Shokat (2005). "Multiple Eruptive Dermatofibromas Occurring in a Patient with Myelodysplastic Syndrome". Acta Dermato-Venereologica. -1 (1): 1–1. doi:10.1080/00015550410024517. ISSN 0001-5555.
  9. ↑ I. Lu, P. R. Cohen & M. E. Grossman (1995). "Multiple dermatofibromas in a woman with HIV infection and systemic lupus erythematosus". Journal of the American Academy of Dermatology. 32 (5 Pt 2): 901–903. doi:10.1016/0190-9622(95)91558-3. PMID 7722054.
  10. ↑ P. R. Cohen (1991). "Multiple dermatofibromas in patients with autoimmune disorders receiving immunosuppressive therapy". International journal of dermatology. 30 (4): 266–270. PMID 2050454.
  11. ↑ Mayuri Tanaka, Toshihiko Hoashi, Naotaka Serizawa, Kyochika Okabe, Susumu Ichiyama, Rie Shinohara, Yoko Funasaka & Hidehisa Saeki (2017). "Multiple unilaterally localized dermatofibromas in a patient with Down syndrome". The Journal of dermatology. 44 (9): 1074–1076. doi:10.1111/1346-8138.13625. PMID 27665731.
  12. ↑ J. Stainforth & M. J. Goodfield (1994). "Multiple dermatofibromata developing during pregnancy". Clinical and experimental dermatology. 19 (1): 59–60. PMID 8313640.
  13. ↑ Yuichiro Tsunemi, Hironobu Ihn, Naoko Hattori, Hidehisa Saeki & Kunihiko Tamaki (2003). "Multiple eruptive dermatofibromas with CD34+ cells in a patient with hypertriglyceridemia". Dermatology (Basel, Switzerland). 207 (3): 319–321. doi:10.1159/000073098. PMID 14571078.
  14. ↑ H. B. Bargman & I. Fefferman (1986). "Multiple dermatofibromas in a patient with myasthenia gravis treated with prednisone and cyclophosphamide". Journal of the American Academy of Dermatology. 14 (2 Pt 2): 351–352. doi:10.1016/s0190-9622(86)70041-8. PMID 3950136.
  15. ↑ S. E. Chang, J. H. Choi, K. J. Sung, K. C. Moon & J. K. Koh (2000). "Multiple eruptive dermatofibromas occurring in a patient with acute myeloid leukaemia". The British journal of dermatology. 142 (5): 1062–1063. doi:10.1046/j.1365-2133.2000.03508.x. PMID 10809884.
  16. ↑ LeBoit, P. E. (2006). Pathology and genetics of skin tumours. Lyon: IARC Press. ISBN 9283224140.
  17. ↑ Lee, MiWoo; Lee, WooJin; Jung, JoonMin; Won, ChongHyun; Chang, SungEun; Choi, JeeHo; Moon, KeeChan (2015). "Clinical and histological patterns of dermatofibroma without gross skin surface change: A comparative study with conventional dermatofibroma". Indian Journal of Dermatology, Venereology, and Leprology. 81 (3): 263. doi:10.4103/0378-6323.154795. ISSN 0378-6323.
  18. ↑ Mentzel, Thomas; Wiesner, Thomas; Cerroni, Lorenzo; Hantschke, Markus; Kutzner, Heinz; Rütten, Arno; Häberle, Michael; Bisceglia, Michele; Chibon, Frederic; Coindre, Jean-Michel (2012). "Malignant dermatofibroma: clinicopathological, immunohistochemical, and molecular analysis of seven cases". Modern Pathology. 26 (2): 256–267. doi:10.1038/modpathol.2012.157. ISSN 0893-3952.
  19. ↑ Victor, Thomas A. (2003). "Neoplasms With Follicular Differentiation, 2nd ed. A. BERNARD ACKERMAN, VIJAYA B. REDDY, AND H. PETER SOYER, eds". Dermatologic Surgery. 29 (6): 641–641. doi:10.1046/j.1524-4725.2003.29153.x. ISSN 1076-0512.
Retrieved from "https://www.wikidoc.org/index.php?title=Dermatofibroma_pathophysiology&oldid=1636996"