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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Accuracy Of Tests For Dermatofibroma?

What is the accuracy rates or statistics of a VISUAL exam diagnosing Dermatofibroma and it being correct?







I have a total of three knots currently. One on my right arm, one on my right buttock, and one on the external portion of the vagina slightly above the clitoris. My mother, grandfather, and aunt have all had melanoma cancer. Since the knots were concerning (light brown in color few slight speckles of black but nothing major on the buttocks and arm and one on vagina is skin toned - one on arm and buttocks size of a dime and one on vagina size of a b b - all somewhat of an odd circular shape) I went to the dermatologist after a friend (doctor) at cancer research suggested doing so. The Dermatologist visually diagnosed the one on my arm and buttocks (didnt mention the vagina as I thought it might be from shaving or something like that and gynecologist apt the following day) as dermatofibroma . During the exams there was a spot found on my back (upper right side near the arm pitt area) which was biopsied using the shave technique. The biopsy came back positive for melanoma and referred me to a surgeon which I see Friday 2/12/10 for initial over view I would assume and date of expected operation. The wound stung and began to tingle around it and after a few days the tingle is now up my shoulder. I called the dermatologist and didnt get a call back for several hours and since I work in the ER I asked a Dr for advice (not sure WHAT was going on). She looked to see if it were infected thinking maybe thats pushing on a nerve, it wasnt. She said she believes during the biopsy he may have damaged a nerve. The dermatologist finally called back and told me if its not infected (I informed him the ER dr said its not) then its a coincidence and has nothing to do with the biopsy and cancer spot at all. (Tingling still there and NO ANSWERS AS TO WHY other than from the ER dr and what she believes- has anyone had this? I would assume its rare but it WONT GO AWAY!) I then informed him during the phone call of the lump in the vaginal area because my Gyno was stumped saying "maybe its a form of skin tag. Watch it and let me know if it changes and if so we certainly need to remove." The Derm said "its likely dermatofibroma." I asked if that was common and he said NO and I asked if he had ever had a patient with it and he said NO and after looking it up NO!!! The Derm won't biopsy the three lumps to make an OFFICIAL pathologist reported diagnosis for the dermatofibroma insisting there is no point because they will just come back. My ER dr who has had melanoma was furious he left the knots on (she seen the one on arm and buttocks) and insisted, her exact words, "HE IS A QUACK!." She insists I consult the surgeon and insist on removal of ALL the lumps. I have no idea whats going on, and the derm didnt really tell me anything but I have to see a surgeon, the name, and number. What do I expect? Can I insist on these being removed as well or at least if I express my concern is it an option at that point or do I need? I am getting laid off in a month and my insurance will be gone till I find new employment (which im looking) and get more insurance. Surgery will be soon and there are no other Dermatologists who can get me in soon for a second dermo opinion, earliest being May!!! So how accuarte are dermatologists with diagnosing dermatofibroma visually with no kind of test? Has anyone had anything similar? And I read there are even differnt types of Dermatofibroma! I also had pre existing pre cancerous cervical cells (told 6 yrs ago) that I had checked during the pap and am awaiting results (I dont think I have anything just being cautious at this point) if the info helps. I need HELP! Another opinion from someone who is experienced in a field or from personal experience. Melanoma is potentially fatal. I feel like there is a spider on me that is poisonous at full grown and the dr's are saying wait till the baby gets ready to bite. I dont want to wait for the poisonous spider to bite me, ya know? Squash it before it does in case the treatment dont make it before the poison takes over. HELP!!!

** and as for the vaginal bump the gynecologist confirms the lump is not a result of an std etc (My BF is soooooo lucky or he'd pay!)

** I already know I am in need of a new Dermatologist

Wed, 4 Feb 2015
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Pathologist and Microbiologist 's  Response
Hi! thanks for your detailed description and also feel sorry for the dilemma/embarrassments you are going through!

Well, your concern is between melanoma and dermatofibroma!

No problem only histopathology / biopsy confirms this; therefore share with us the detailed histopathology report and immunohistochemistry reports if done...

In fact, immunohistochemistry is one of the best technologies that clearly distinguishes between the two! You need more histopathologist's opinion more rather than a dermatologist's opinion!

Hope you got your answer. Please feel free to write to us if any more queries.

Wishing you early solution!
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What Is The Accuracy Of Tests For Dermatofibroma?

Hi! thanks for your detailed description and also feel sorry for the dilemma/embarrassments you are going through! Well, your concern is between melanoma and dermatofibroma! No problem only histopathology / biopsy confirms this; therefore share with us the detailed histopathology report and immunohistochemistry reports if done... In fact, immunohistochemistry is one of the best technologies that clearly distinguishes between the two! You need more histopathologist s opinion more rather than a dermatologist s opinion! Hope you got your answer. Please feel free to write to us if any more queries. Wishing you early solution!