Location
Philadelphia, PA
Start Date
30-4-2025 1:00 PM
End Date
30-4-2025 4:00 PM
Description
Plaque-like CD34+ dermal fibroma (PDF), also referred to as medallion-like dermal dendrocyte hamartoma (MLDDH), is a rare, benign dermal neoplasm that typically presents as a slow-growing, asymptomatic plaque. PDF is most commonly seen on the neck or trunk of young women. The pathogenesis of PDF remains poorly understood. Histologically, these lesions are characterized by the proliferation of spindle-shaped fibroblasts in the dermis, which are strongly positive for CD34 and negative for markers such as S100, Melan-A, and Factor XIIIa.
We present a case of a 57-year-old female with a one-year history of a plaque-like CD34+ dermal fibroma on the dorsal surface of her left first toe. The lesion was asymptomatic but had been gradually increasing in size and changing color over several months, prompting clinical investigation. A tangential biopsy was performed. Histopathological analysis confirmed the diagnosis, revealing a neoplasm of wavy and spindle-shaped cells predominantly arranged in parallel fascicles that interweave within the upper reticular dermis. The immunohistochemical profile demonstrated strong positivity for CD34, with negative staining for S100, Melan-A, and Factor XIIIa, further supporting the diagnosis. Given that the lesion is unusual in this patient’s age group, complete removal was recommended. The lesion was successfully excised with clear margins, and the patient had a generally uncomplicated postoperative course. At the 10-day postoperative follow-up, mild redness and pain were noted, which resolved without signs of progressive infection. Gram stain and bacterial cultures were taken, both of which returned negative results. There was no recurrence of the lesion.
A comprehensive review of the literature identifies a limited number of reported cases of plaque-like CD34+ dermal fibromas, most of which are located on the neck or trunk, with few cases involving the proximal extremities. Notably, there have been no reports of these lesions occurring on the distal extremities. To our knowledge, this is the first documented case of a plaque-like CD34+ dermal fibroma occurring on the toe..
Embargo Period
5-29-2025
Included in
Plaque-like CD34+ dermal fibroma on the toe: A case report and literature review
Philadelphia, PA
Plaque-like CD34+ dermal fibroma (PDF), also referred to as medallion-like dermal dendrocyte hamartoma (MLDDH), is a rare, benign dermal neoplasm that typically presents as a slow-growing, asymptomatic plaque. PDF is most commonly seen on the neck or trunk of young women. The pathogenesis of PDF remains poorly understood. Histologically, these lesions are characterized by the proliferation of spindle-shaped fibroblasts in the dermis, which are strongly positive for CD34 and negative for markers such as S100, Melan-A, and Factor XIIIa.
We present a case of a 57-year-old female with a one-year history of a plaque-like CD34+ dermal fibroma on the dorsal surface of her left first toe. The lesion was asymptomatic but had been gradually increasing in size and changing color over several months, prompting clinical investigation. A tangential biopsy was performed. Histopathological analysis confirmed the diagnosis, revealing a neoplasm of wavy and spindle-shaped cells predominantly arranged in parallel fascicles that interweave within the upper reticular dermis. The immunohistochemical profile demonstrated strong positivity for CD34, with negative staining for S100, Melan-A, and Factor XIIIa, further supporting the diagnosis. Given that the lesion is unusual in this patient’s age group, complete removal was recommended. The lesion was successfully excised with clear margins, and the patient had a generally uncomplicated postoperative course. At the 10-day postoperative follow-up, mild redness and pain were noted, which resolved without signs of progressive infection. Gram stain and bacterial cultures were taken, both of which returned negative results. There was no recurrence of the lesion.
A comprehensive review of the literature identifies a limited number of reported cases of plaque-like CD34+ dermal fibromas, most of which are located on the neck or trunk, with few cases involving the proximal extremities. Notably, there have been no reports of these lesions occurring on the distal extremities. To our knowledge, this is the first documented case of a plaque-like CD34+ dermal fibroma occurring on the toe..