Introduction

Dermatofibroma is the third and final benign pattern in the TADA algorithm. With seborrhoeic keratosis and cherry angioma now in your visual library, dermatofibroma completes the trio of lesions you can identify with enough confidence to stop the assessment and reassure the patient.

Dermatofibromas are common, benign, and usually straightforward under the dermatoscope. Their dermoscopic pattern is distinctive — a central white patch surrounded by a delicate pigment network — and once you have seen it a few times, it becomes instantly recognisable.

But dermatofibroma also introduces an important concept: the interplay between fibrosis and pigment. The central white area is not simply an absence of colour — it is an active structural feature caused by scar-like tissue pushing the epidermis upward. Understanding why the pattern looks the way it does will help you read fibrotic features in other lesion types as well.

What you will learn

1. Recognise the classic dermoscopic features of dermatofibroma
2. Understand the structural basis of the central white patch
3. Use the dimple sign as a clinical correlation tool
4. Identify common variants and atypical presentations
5. Differentiate dermatofibroma from uncommon but important mimickers
6. Know when a dermatofibroma-like lesion warrants further evaluation

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