Congenital multiple clustered dermatofibroma and multiple eruptive\ndermatofibromas - unusual presentations of a common entity
A 42-year-old woman presented with a 3month history of rapidly-developing generalized\nbrown papules and nodules. She complained that some of these lesions were painful.\nHer past medical history included a Sjögren Syndrome diagnosed the previous year\n(xerophthalmia, xerostomia, positive anti-SSA antibodies, Schirmer test, salivary\nscintigraphy and minor salivary gland biopsy), for which she was on artificial tears\nand regular oral fluoride treatments. Physical examination revealed multiple (20-30)\nfirm brown papules and nodules of 5-15 mm in diameter, with positive dimple sign,\ndistributed on the trunk, upper and lower limbs ( and ). Histopathological\nexamination showed features similar to the ones found on the previous patient: a\nspindle cell proliferation in the dermis that dissociated the collagen, superimposed\nby a hyperplastic epidermis with hyperpigmented basal layer; these features were\ncompatible with a dermatofibroma. Laboratory tests revealed the changes expected to\nbe found in a patient with Sjögren's Syndrome - increased erythrocyte sedimentation\nrate (38 mm, normal 0-19), anti-SSA antibodies (240,0 U/µL, normal < 10) and\nantinuclear antibodies (1/640, normal < 1/80). The diagnosis of multiple eruptive\ndermatofibromas in a patient with Sjögren's Syndrome was made. Surgical excision of\nthe painful lesions was performed and the patient has been kept under\nsurveillance.