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Dr. Lori
Dr. Lori, Family Physician
Category: Dermatology
Satisfied Customers: 1209
Experience:  Board Certified Family Physician for 12+ yrs, Extensive Derm exper. & wound care
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I have a firm round bump on my arm. It is raised and I would

Resolved Question:

I have a firm round bump on my arm. It is raised and I would describe its skin color as skin tone to pinkish/red. I have picked at it frequently / pinched it frequently making it a little darker than it actually is I believe. I have been picking at it since septemper / october of 2009. I remember something being in the same spot int the past a smaller bump I believe but Im not 100% sure. It seemed to grow after picking late last year. Its less than a half inch in diamter / prob around a 1/4. I thought it was a dermatfibroma but have recently gotten worried bc the consor seems to be solid throughout the entire lesion and it does not tend to dimple like the pictures of dermatifibroma dimples online. When i pinch it a small area in the center compersses (dimples) but the edges (margins do not) just the denter - almost like a crater. When I press on it and lift my finger the color tends to fade. I have a dr appointment later but have beg worrying bc the dimple isnt thes as picktures i see
Submitted: 6 years ago.
Category: Dermatology
Expert:  Dr. Lori replied 6 years ago.

HI-

 

What you are describing could still very well be a dermatofibroma. The "dimpling" you are referring to is when the lesion is pinched from the outer aspects of its rim, the lesion goes downward like into the skin, while skin around it does not depress.

This is what happens because the lesion is fibrous, and like tacked down to the lower dermis. Very few dermatobibromas have a dimpled center where a hair follicle previously was- but this doesn't make the diagnosis as much as the lesion going down (depressing) when pinched.

 

Pictures of dermatofibromas:

 

http://www.dermis.net/dermisroot/en/1269322/image.htm

http://www.dermis.net/dermisroot/en/22362/image.htm

http://www.dermis.net/dermisroot/en/22358/image.htm

 

So- I wouldn't worry because of the dimple issue-

Many biopsies we do come back as DF, even when we worry it can be something else.

So, have faith in your doc, and allow him to make the call-

 

Odds are highly in your favor that he will be right.

Any change of the lesion, color change, increased size etc....

Biopsy would be prudent.

 

Please ask me questions you need for clarity!

 

Be well and fret not!

 

My Best--

Customer: replied 6 years ago.
I am really worried bc of the lack of a dimple, I mean there is no dimpling like you describe at all. It really hasnt changed size since in grew late last year, maybe a bit bigger but I am picking at it alot. Is it to big to be a dermatfibroma if its about an 1/4 in. Could this be anything other than dermatfibroma or nodular melanoma ? And what about it losing color when I press on it, does this signal anything.Thanks for answering
Expert:  Dr. Lori replied 6 years ago.

OK-

 

I see what you mean. No change significant in size this whole time is of HUGE importance. Cancers usually grow in size, develop blood vessels to it, get very hard, and do not lose color when pressed on. So, it is very possible this is a little hemangioma, or venous lake-- these blanche when you press on them. That is a good sign, since melanomas don't lose color with pressure- and in the skin- melanoma is what is the most worrisome.

 

Your picking at it is probably causing scarring which is firm- so this could be a simple skin problem gone awry from scarring.

So again--- things that make us worry- - growth in size, darker in color that does not go away with anything, tiny blood vessels that are visible growing to it.

 

The picking could have made a dermatofibroma seem to grow from scarring, and change the dimpling. But, for me the reassuring parts are that the size is the same, it does blanche with pressure, and no pain etc.

 

If you keep picking something benign, it can turn into a cancer-

So stop picking at it, and have a doc see it. It is likely a benign skin structure, and does not need to be a fibroma- and the blanching part may simply mean it is a blood vessel structure, but instead of guessing and worrying, have someone look at it.

 

This kind of thing is easy to biopsy, and that could make 100% of your worry go away!

So stop worrying because of the dimpling you don't see. The things to worry about is if color turns black, size gets much bigger, the edges are jaggedy and the color is not uniform throughout.

 

I have a hunch all the changes are from picking at it, not because it is a tumor that is cancerous.

 

So, take a deep breath. Stop picking. And keep your appointment.

You will have a much clearer diagnosis then.

 

Hang in there, stop worrying so much.

There are many more benign things we see in the skin than there are cancers.

 

 

My Best--

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