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 © 2001-2009, DermAtlas | Image Name: | acquired_digital_fibrokeratoma_1_081210 | File Type: | jpg | |
| Diagnosis: | DIGITAL FIBROKERATOMA, ACQUIRED | Category: | neoplasm, fibrohistiocytic / neoplasm, benign | ||
| Body Site: | toe / foot | Age: | 29 years | ||
| Contributor: | Yashpal Manchanda, MD | ||||
| Description: | 1 cm scaly skin colored nodule | ||||
| Comments: | This 29-year-old man complained of an asymptomatic growth on his right fourth toe for 2 years. A biopsy confirmed the diagnosis of acquired digital fibrokeratoma. | ||||
 © 2001-2009, DermAtlas | Image Name: | acquired_digital_fibrokeratoma_1_080819 | File Type: | jpg | |
| Diagnosis: | DIGITAL FIBROKERATOMA, ACQUIRED | Category: | lumps & bumps (plaques, nodules, tumors) / neoplasm, fibrohistiocytic | ||
| Body Site: | toe | Age: | 24 years | ||
| Contributor: | Yashpal Manchanda, MD | ||||
| Description: | firm elongated 1.5 cm skin colored papule with some surroudning scale | ||||
| Comments: | This 24-year-old man complained of an irritated papule on the dorsolateral aspect of the right fourth toe for 4 years. Biopsy showed a digital fibrokeratoma. | ||||
 © 2001-2009, DermAtlas | Image Name: | myofibroma_1_080801 | File Type: | jpg | |
| Diagnosis: | MYOFIBROMA | Category: | neoplasm, fibrohistiocytic / neoplasm, benign | ||
| Body Site: | nose | Age: | 35 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is a cellular and fibrous lesion, appearing well-circumscribed and possibly "shelled-out". There are alternating zones of hyper- and hypocellularity. The periphery of the lesion is hyalinized. | ||||
| Comments: | This 35 year old man presented with a solitary lesion on the nasal bridge. It was submitted as a possible cyst. Adult myofibromas are rare and often occur on the head and neck. Its histogenesis is unclear but probably is of myofibroblastic lineage, as demonstrated by muscle actin staining, as in this case. Individual lesions resemble those in juvenile myofibromatosis but usually have more hyalinized areas and less hemangiopericytomatous areas. These are benign but may recur when incompletely excised. | ||||
| Related Images: | All related Images myofibroma_3_sma_080801 myofibroma_2_080801 | ||||
 © 2001-2009, DermAtlas | Image Name: | myofibroma_2_080801 | File Type: | jpg | |
| Diagnosis: | MYOFIBROMA | Category: | neoplasm, fibrohistiocytic / neoplasm, benign | ||
| Body Site: | nose | Age: | 35 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | This higher power highlights the striking hyalinized stroma. Cytologic atypia is not impressive. Mitotic activity is rare. | ||||
| Comments: | This 35 year old man presented with a solitary lesion on the nasal bridge. It was submitted as a possible cyst. Adult myofibromas are rare and often occur on the head and neck. Its histogenesis is unclear but probably is of myofibroblastic lineage, as demonstrated by muscle actin staining, as in this case. Individual lesions resemble those in juvenile myofibromatosis but usually have more hyalinized areas and less hemangiopericytomatous areas. These are benign but may recur when incompletely excised. | ||||
| Related Images: | All related Images myofibroma_3_sma_080801 myofibroma_1_080801 | ||||
 © 2001-2009, DermAtlas | Image Name: | myofibroma_3_sma_080801 | File Type: | jpg | |
| Diagnosis: | MYOFIBROMA | Category: | neoplasm, fibrohistiocytic / neoplasm, benign | ||
| Body Site: | nose | Age: | 35 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | A muscle-specific actin immunostain is diffusely positive. | ||||
| Comments: | This 35 year old man presented with a solitary lesion on the nasal bridge. It was submitted as a possible cyst. Adult myofibromas are rare and often occur on the head and neck. Its histogenesis is unclear but probably is of myofibroblastic lineage, as demonstrated by muscle actin staining, as in this case. Individual lesions resemble those in juvenile myofibromatosis but usually have more hyalinized areas and less hemangiopericytomatous areas. These are benign but may recur when incompletely excised. | ||||
| Related Images: | All related Images myofibroma_2_080801 myofibroma_1_080801 | ||||
 © 2001-2009, DermAtlas | Image Name: | superficial_acral_fibromyxoma_1_071101 | File Type: | jpg | |
| Diagnosis: | SUPERFICIAL ACRAL FIBROMYXOMA | Category: | neoplasm, fibrohistiocytic / neoplasm, benign | ||
| Body Site: | toe | Age: | 51 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The biopsy is of acral skin and there is a spindle cell tumor within the superficial dermis. | ||||
| Comments: | This is a rare benign tumor, found on fingers and toes of young to middle-age males, usually. It is often submitted as a fibrokeratoma or neurofibroma. Immunohistochemistry can be used to exclude other tumors, but the immunoprofile is not specific in itself (CD34+, EMA +/-). | ||||
| Related Images: | superficial_acral_fibromyxoma_2_071101 | ||||
 © 2001-2009, DermAtlas | Image Name: | superficial_acral_fibromyxoma_2_071101 | File Type: | jpg | |
| Diagnosis: | SUPERFICIAL ACRAL FIBROMYXOMA | Category: | neoplasm, fibrohistiocytic / neoplasm, benign | ||
| Body Site: | toe | Age: | 51 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The spindle cells are short with moderately abundant pink cytoplasm. There are alternating zones of mucinous/myxoid and sclerotic stroma and the tumor cells have a vague storiform pattern. Cytologic atypia or mitoses are not found. | ||||
| Comments: | This is a rare benign tumor, found on fingers and toes of young to middle-age males, usually. It is often submitted as a fibrokeratoma or neurofibroma. Immunohistochemistry can be used to exclude other tumors, but the immunoprofile is not specific in itself (CD34+, EMA +/-). | ||||
| Related Images: | superficial_acral_fibromyxoma_1_071101 | ||||
 © 2001-2009, DermAtlas | Image Name: | acquired_digital_fibrokeratoma_1_070411 | File Type: | jpg | |
| Diagnosis: | ACQUIRED DIGITAL FIBROKERATOMA / ACRAL FIBROKERATOMA | Category: | neoplasm, fibrohistiocytic / neoplasm, benign | ||
| Body Site: | toe | Age: | 28 years | ||
| Contributors: | Alde Carlo Gavino, MD Greg Hosler, MD, PhD | ||||
| Description: | Histologic examination of the lesion reveals a dermal proliferation of dense, hyalinized collagen bundles haphazardly arranged perpendicular to the overlying orthohyperkeratotic epidermis. There are sparse fibroblasts and few blood vessels present. | ||||
| Comments: | This 28-year old woman presented with a 0.7-centimeter white nodule on her right toe. Acquired digital fibrokeratoma (ADFK) typically occurs on the fingers or toes of adults and presents as an indolent nodule that rarely exceeds 1.5 centimeters in size. It is usually of no clinical significance but may be confused histologically with periungual fibromas seen in tuberous sclerosis. The presence of multinucleated and stellate cells in the latter help distinguish it from ADFK. The differential diagnosis of ADFK also includes an accessory digit, knuckle pad, sclerotic fibroma, and dermatofibroma. The clinical history is key to differentiating an accessory digit and a knuckle pad from ADFK. Moreover, nerve bundles are particularly prominent in an accessory digit. In sclerotic fibroma and dermatofibroma, the collagen bundles are thinner and are usually arranged in a storiform, rather than a haphazard, pattern. Although a traumatic cause is favored by some, the pathogenesis of ADFK is not currently known. | ||||
 © 2001-2009, DermAtlas | Image Name: | fibroma_sclerotic_2_060801 | File Type: | jpg | |
| Diagnosis: | FIBROMA, SCLEROTIC / STORIFORM COLLAGENOMA / FIBROMA | Category: | neoplasm, fibrohistiocytic / neoplasm, benign / genodermatosis/genetic disorder | ||
| Body Site: | neck | Age: | 63 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The collagen is in a storiform pattern. Some have referred to this as 'plywood' pattern. The lesion is hypocellular with few spindle-to stellate cells distributed throughout. These cells stain positive for Factor XIIIa (not shown). | ||||
| Comments: | Sclerotic fibroma, or storiform collagenoma, is an unusual but distinctive lesion. The typical features are of those described here. Although often idiopathic, when multiple, these lesions have been associated with Cowden disease. | ||||
| Related Images: | fibroma_sclerotic_1_060801 | ||||
 © 2001-2009, DermAtlas | Image Name: | fibroma_sclerotic_1_060801 | File Type: | jpg | |
| Diagnosis: | FIBROMA, SCLEROTIC / STORIFORM COLLAGENOMA / FIBROMA | Category: | neoplasm, fibrohistiocytic / neoplasm, benign / genodermatosis/genetic disorder | ||
| Body Site: | neck | Age: | 63 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is a circumscribed but unencapsulated fibrous lesion within the dermis. The overlying epidermis is attenuated, forming a slight collarette. The lesion is strikingly hypocellular. | ||||
| Comments: | Sclerotic fibroma, or storiform collagenoma, is an unusual but distinctive lesion. The typical features are of those described here. Although often idiopathic, when multiple, these lesions have been associated with Cowden disease. | ||||
| Related Images: | fibroma_sclerotic_2_060801 | ||||
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