FIBROUS HISTIOCYTOMA

SYMPTOMS

A fibrous histiocytoma typically presents as small, firm, dome-shaped nodules or plaques on the skin. They may vary in color, ranging from flesh-colored to reddish-brown or purplish. Common characteristics of fibrous histiocytomas include:

• Slow-growing: Fibrous histiocytomas tend to grow slowly over time and may remain stable in size or spontaneously regress.
• Painlessness: Fibrous histiocytomas are usually painless, although they may become tender or irritated if traumatized or inflamed.
• Surface changes: The surface of a fibrous histiocytoma may be smooth, rough, or dimpled, resembling the texture of an orange peel.
• Fixation to the skin: Fibrous histiocytomas are typically fixed to the overlying skin and do not move freely when palpated.

DIAGNOSIS

Diagnosing fibrous histiocytoma usually involves a combination of clinical evaluation and histopathological examination. Diagnostic steps may include:

• Clinical examination: A healthcare provider will perform a thorough examination of the skin, noting the characteristics of the lesion, its size, shape, color, and texture.
• Dermoscopy: Dermoscopy, or dermatoscopy, is a non-invasive technique that allows for the magnified examination of skin lesions. Certain dermoscopic features, such as a central white scar-like area surrounded by a pigment network, may be suggestive of fibrous histiocytoma.
• Biopsy: A skin biopsy may be performed to obtain a tissue sample from the lesion for histopathological examination. Histological features of fibrous histiocytoma include spindle-shaped fibroblasts, histiocytes, and collagen bundles within the dermis.

TREATMENT

Treatment options for fibrous histiocytoma depend on various factors, including the size, location, and symptoms associated with the lesion. Treatment modalities may include:

• Observation: In many cases, fibrous histiocytomas are asymptomatic and do not require treatment. Observation with regular monitoring may be recommended to assess for changes in size, shape, or symptoms.
• Surgical excision: Surgical removal of the fibrous histiocytoma is often performed for cosmetic reasons or if the lesion is causing discomfort, irritation, or functional impairment. Excision may be performed using local anesthesia in an outpatient setting.
• Cryotherapy: Cryotherapy, or freezing, may be used to treat smaller fibrous histiocytomas by applying liquid nitrogen to the lesion, causing tissue destruction and subsequent resolution.
• Laser therapy: Laser ablation or laser excision may be considered for fibrous histiocytomas located in cosmetically sensitive areas or for lesions resistant to other treatment modalities.