Desmoplastic naevus

LAST UPDATED: Oct 30, 2025

Introduction

A desmoplastic naevus is a rare benign melanocytic naevus characterised by predominantly spindle-shaped naevus cells within a fibrotic stroma. It is regarded by some as a type of Spitz naevus, by others as a distinct entity.

This chapter is set out as follows:

History
Clinical findings
Images
Management

History

More common in adults than children, and most frequently arises in the third decade
Female predominance

Clinical findings

Distribution

Although any body site can be affected, it occurs most commonly on the limbs

Morphology

A solitary, well-circumscribed, smooth, pink-red-brown papule or nodule
Lesions can be dome-shaped or flat-topped
Woody-hard on palpation
Differential diagnosis - lesions can have a similar clinical appearance to a dermatofibroma, keloid scar, classical Spitz naevus and a desmoplastic melanoma

Clinical Images

Please refer to notes on image rights at bottom of the page with regards to individual image ownership.

Management

Although benign, diagnostic uncertainty should prompt an urgent skin cancer referral - lesions are usually excised, histologically the differential diagnosis rests mainly with a desmoplastic melanoma
Desmoplastic naevi follow a benign clinical course and do not recur after complete excision

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