Removal of a Dermatofibroma Behind Knee (Insect Bite)

I've dermatofibroma behind my knee, got it from insect bite,doesn't hurt, but itches alot. My dermatologist said I can have it removed, but itll leave a scar, it'll have 2 b cut below the skin. Ive read that if this isnt completely removed it can come back, so I want 2 make sure its completely removed. Ive also gone 2 a plastic surgeon who understand dermatofibormas & said he would cut under 2 the skin 2 remove it. Since scaring is possible, should I go 2 dermatologist or plastic surgeon? ty

Doctor Answers 3

If really a dermatofibroma, then leave it alone.

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Regardless of who removes it (derm or plastics), the technique is the same--an excision.  And the scar is usually worse than the original spot after an excision. So if truly a DF, leave it alone. Alternatively, if really raised you might consider just having your doc shave it down to tangentially debulk it--but even still, the scar might be more prominent than the original spot.

Greenwood Village Dermatologic Surgeon

I would re-think removing dermatofibroma

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I would give this surgery a second thought. If your dermatologist thinks that this is a classic benign dermatofibroma you might not be happy with removing it. The scar will be longer that the lesion is to adequately close it. Who removes it will make no difference as both doctors will do an identical procedure.  Sometimes these can be frozen with liquid nitrogen and they will shrink and be less symptomatic. If you are removing because it itches how can you be sure that the scar won't itch too. I
 love doing surgery but this is one that I do my best to discourage. 

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Scarring after the removal of a Dermatofibroma

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Thie issue here is not really one of a dermatologist versus plastic surgeon but of what happens once an incison has been made into  the skin.  In fact the one thing I would strongly advise you is to avoid the physician who guarantees there will be no scar.  Whenever the skin has been cut there are risks one of which is for potential scarring.  This risk occurrs regardless of who is holding the knife.  The risk of scarring can be related to many factors some of which include surgical location (the leg is more prone to scarring especially in area that is subject to constant motion), history of piror wound healing, underlying medical problems, smoking amongst many other issues.  Hopefully, the dermatolgist has explained that since dermatofibromas are benign they can be left alone if the patient desires.  Since potential scarring is of utmost concern to you I wouldn't remove this lesion unless you were understanding of the risk.

Ted Brezel, MD
Long Island Dermatologic Surgeon

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