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Multiple Dermatofibromas ! & "# ' $ ! ( ! ! ! % ) The epidermis exhibits regular hyperplasia and increased basal layer pigmentation. In the dermis, there is a spindle cell proliferation composed of cells with tapered ends, small nuclei and vacuolated cytoplasm-arranged in fascicles and merging with the surrounding connective tissue. Masson trichrome: fibrous tumor. Alcian blue, iron, vimentin stains: positive. Desmin & S100 stains: negative. * +$+! ! ! *, ! - Dermatofibroma (DF) commonly occurs as a solitary lesion over lower extremities, more frequently in women than men. Multiple dermatofibromas have been reported in association with systemic diseases mainly immunosuppression, autoimmune diseases, pregnancy, hyperlipidemia, diabetes and kidney disease. It is suggested that DF represents the outcome of an abortive immune response to an unidentified antigenic stimulus such as insect saliva, trauma….leading to an inflammatory proliferation of dermal dendritic cells. ./ -Sharata H, Hashimoto K, Fernandez-Madrid F. Multiple hyperpigmented nodules. Multiple dermatofibromas in a patient with systemic lupus erythematous. Arch Dermatol 1994; 130: 650l, 653. -Ammirati CT, Mann C, Hornstra IK. Multiple eruptive dermatofibromas in three men with HIV infection. Dermatology 1997; 195: 344-8. - Nestle FO, Nickoloff BJ, Burg G. Dermatofibroma: an abortive immunoreactive process mediated by dermal dendritic cells? Dermatology 1995;190:265-8. -YamamotoT, Katayama I, Nishioka K. Involvement of basic fibroblast growth factor in fibroblast-stimulatory serum activity of a patient with systemic lupus erythematosus and multiple dermatofibromas. Dermatology 1995; 191; 281 – 5.