Dermatofibrosarcoma protuberans (DFSP): Signs and symptoms

                dermatofibroma Dermatofibroma: DFSP often looks like this harmless and common skin growth, a dermatofibroma.

                DFSP on a child’s skin DFSP on a child’s skin: In children, this skin cancer tends to resemble a birthmark.

                DFSP can look like a scar DFSP: The first sign of this skin cancer may be reddish brown or pink patch of raised skin that looks like a scar.

                advanced DFSP DFSP: Given time to grow, many protuberans can appear on the surface of the skin.

Early signs and symptoms of DFSP

This skin cancer tends to grow slowly so it often goes unnoticed for months — or even years. When dermatofibrosarcoma protuberans (DFSP) first appears on the skin, a person may notice:

  • A pimple-like growth or rough patch of skin.
  • No pain or tenderness where the growth or patch forms.
  • Little change in the growth or patch.

As the skin cancer grows

As DFSP grows inside the middle layer of skin, it tends to push on the top layer of skin. You may see a lump, also known as a protuberan (pro-to-bur-an). The lump may feel hard or rubbery. As the lump grows, it stretches the skin. You may notice that the affected skin:

  • Becomes tender.
  • Cracks and bleeds.
  • Feels hard, and the lump seems cemented in the skin.

When a woman is pregnant, DFSP tends to grow more quickly.

Over time, more protuberans (lumps) can appear. Once these appear, DFSP tends to grow quickly. In adults, the protuberans often range in color from reddish brown to violet. In young patients, DFSP tends to be blue or red in color.

Where DFSP forms on the body

DFSP can form anywhere on the skin. It is, however, more likely to develop on the:

  • Trunk (chest, back, abdomen, shoulder, buttocks).
  • Arm or leg.

Few DFSPs form above the neck, but it is possible to find this skin cancer on the scalp or inside the mouth.

When to see a dermatologist

If you are worried about a growth on your skin, you should see a dermatologist. Many skin growths look alike. DFSP often looks like a harmless skin growth known as a dermatofibroma (shown above). This harmless skin growth rarely needs treatment. DFSP always requires treatment.

Dermatologists receive specialized training in diagnosing and treating skin cancer. This expertise is helpful when a person has a rare skin cancer like DFSP.

More common in younger people

DFSP tends to occur between the ages of 20 and 50. To find out more about who is more likely to get this skin cancer, read DFSP: Who gets and causes.

Learn more about dermatofibrosarcoma protuberans:

Images used with permission of Journal of the American Academy of Dermatology:

  • J Am Acad Dermatol 2010;62:247-56.
  • J Am Acad Dermatol 2009;61:1014-23.
  • J Am Acad Dermatol 2003;49:761-4.
  • J Am Acad Dermatol 2002;46:408-13


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Checketts SR, Hamilton TK, Baughman RD. “Congenital and childhood dermatofibrosarcoma protuberans: a case report and review of the literature.” J Am Acad Dermatol. 2000;42(5 Pt 2):907-13.

Criscione VD, Weinstock MA. “Descriptive epidemiology of dermatofibrosarcoma protuberans in the United States, 1973 to 2002.” J Am Acad Dermatol. 2007;56(6):968-73.

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Halpern M, Chen E, Ratner D. “Sarcomas.” In Nouri K. [editor]. Skin Cancer. United States. McGraw Hill Medical; 2008. p. 217-18.

Irarrazaval I, Redondo P. “Three-dimensional histology for dermatofibrosarcoma protuberans: case series and surgical technique.” J Am Acad Dermatol. 2012 Nov;67(5):991-6.

Kurlander DE, Martires KJ, Chen Y et al. “Risk of subsequent primary malignancies after dermatofibrosarcoma protuberans diagnosis: a national study.” J Am Acad Dermatol 2013;68(5):790-6.

Meehan SA, Napoli JA, Perry AE. “Dermatofibrosarcoma protuberans of the oral cavity.” J Am Acad Dermatol. 199;41(5 Pt 2):863-6.

Stivala A, Lombardo GA, Pompili G. “Dermatofibrosarcoma protuberans: Our experience of 59 cases.” Oncol Lett. 2012; 4(5): 1047–55.

Young RJ, Albertini JG. “Atrophic dermatofibrosarcoma protuberans: case report, review, and proposed molecular mechanisms.” J Am Acad Dermatol 2003;49:761-4.

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