A button tumor is a phrase used by clinicians to describe a skin lesion with a very specific feel and appearance. This term is not a formal medical diagnosis but rather a descriptive, clinical shorthand for a firm, rounded growth that appears pushed into the skin. The morphology, or shape, of the lesion is often the first clue for a dermatologist, distinguishing a “button tumor” from other common skin spots or bumps.
What is a Button Tumor
The term “button tumor” is an older, descriptive label used in dermatology to characterize the physical morphology of a lesion. It refers to a mass that feels like a solid nodule embedded beneath the surface of the skin. This feeling is analogous to pressing a small, rounded object, like a button, into a piece of fabric. The characteristic feature is the palpable firmness of the growth, which often has distinct, well-defined borders.
This clinical term focuses purely on the visual and tactile presentation rather than the cellular pathology of the growth. The description essentially captures a dome-shaped or spherical lesion that is raised above the surrounding skin. This descriptive nature means that the term can be applied to several different conditions, both benign and malignant, which share this specific surface contour. The morphology signals a growth that originates in the deeper layers of the skin, pushing the surface upward.
Distinctive Appearance and Common Locations
The distinctive appearance of a button tumor is defined by its rounded, firm structure and a phenomenon known as the “dimple sign.” Visually, the lesion is a raised, often dome-shaped bump ranging from a few millimeters to a couple of centimeters in diameter. Its color can vary widely, appearing flesh-toned, pink, reddish-brown, or sometimes darker.
The tactile “buttonhole” or “dimple sign” is a key identifier: when lateral pressure is applied to the lesion, the center often retracts or dimples inward. This central depression, which mimics the indentation of a button pressed into the skin, provides the origin for the descriptive name. The skin surrounding the center may appear slightly puckered or retracted.
These lesions can appear anywhere on the body, but certain underlying conditions have preferred anatomical sites. For instance, lesions fitting this description frequently occur on sun-exposed areas like the face, neck, and ears. Other common locations include the limbs and trunk, particularly for growths that are benign and fibrous in nature.
Underlying Conditions Referred to as Button Tumors
The term “button tumor” is a non-specific descriptor applied to different pathological conditions, the most concerning of which is a form of skin cancer. The nodular type of Basal Cell Carcinoma (BCC), the most common form of skin cancer, frequently presents with this morphology. Nodular BCC often begins as a small, pearly or translucent papule that enlarges into a firm, dome-shaped nodule with rolled, raised borders.
As the Nodular BCC grows, it can develop a central depression or ulceration, giving it the classic “button” or “donut” appearance. The surface may also have tiny, visible blood vessels (telangiectasias). The pearly translucency is a hallmark feature distinguishing this malignant growth.
Another common lesion that perfectly fits the “button tumor” description is the Dermatofibroma, a benign growth. Dermatofibromas are an accumulation of extra cells in the dermis, often appearing on the lower legs, arms, or trunk. The characteristic “dimple sign” is most reliably demonstrated by a dermatofibroma, where the central retraction occurs when the skin is pinched. Unlike BCC, Dermatofibromas are typically slow-growing, firm to the touch, and pose no threat of metastasis, though they can sometimes be itchy or tender.
Identifying and Treating the Lesion
Because the same physical appearance can represent both a harmless fibrous growth and a common form of skin cancer, a definitive diagnosis relies on a medical evaluation. A healthcare provider will first perform a visual and tactile examination, including the dimple test, to assess the lesion’s physical characteristics. However, a physical exam alone is insufficient to determine the underlying cell type; the only reliable method is a biopsy.
This procedure involves removing a small sample of the tissue, or sometimes the entire lesion, for microscopic examination by a pathologist. The biopsy results determine whether the growth is a benign Dermatofibroma or a malignant Basal Cell Carcinoma, which dictates the necessary treatment plan.
If the lesion is confirmed to be a benign Dermatofibroma, no treatment is usually necessary, although it can be surgically removed if it causes discomfort or is cosmetically bothersome. When a Basal Cell Carcinoma is confirmed, the standard treatment is complete removal to prevent local tissue destruction. Common methods include surgical excision, where the tumor and a margin of healthy tissue are cut out, or Mohs micrographic surgery, often used for facial lesions to precisely remove cancerous tissue while sparing healthy skin.