Dermoscopy of dermatofibrosarcoma protuberans: A study of 15 cases

Background Dermatofibrosarcoma protuberans (DFSP) is a rare malignant cutaneous tumour of which diagnosis is often delayed because of the lack of early clinical clues. Objectives To describe the main dermoscopic features of DFSP. Methods We performed dermoscopic examination in 15 unselected, consecutive cases of biopsy-proven DFSP. Firstly, six dermoscopic features were identified collegially, then all cases were reviewed separately by six experienced dermoscopists. In a given lesion, features recognized only by all dermoscopists were taken into account. Results The median number of dermoscopic features was four per lesion. The following dermoscopic features were found: delicate pigmented network (87%), vessels (80%), structureless light brown areas (73%), shiny white streaks (67%), pink background coloration (67%) and structureless hypo- or depigmented areas (60%). When detected, vessels were of arborizing type in 11 of 12 cases, and presented as either unfocused only, or both unfocused and focused. Conclusions This first study of the dermoscopic spectrum of DFSP identifies six dermoscopic features (often associated in a multicomponent pattern) and a peculiar vascular pattern. Whether dermoscopy can help to identify suspected DFSP remains to be established by further studies. What's already known about this topic? Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous malignancy in which low clinical specificity often leads to delay in diagnosis. To date, the dermoscopic presentation of DFSP has not been addressed. What does this study add? This preliminary work identifies six dermoscopic features frequently encountered in DFSP, and raises the question of the potential of dermoscopy for the diagnosis of this condition.