Giant acquired digital fibrokeratoma occurring on the left great toe

Acquired Digital Fibrokeratoma: A Report of Five Cases and Review of the Literature

Acquired digital fibrokeratoma (ADF) is rare in clinical practice and is easily misdiagnosed. Herein, 5 cases of patients (3 males and 2 females) with ADF are reported. The mean age at onset was 42.6 years, and the mean disease duration was 3 years. Four patients had ADF on the hands, and 1 patient had ADF on the foot. The clinical manifestations were all solitary, skin-colored papules, with a firm texture and smooth surface, protruding from the skin surface. In 3 patients, ADF manifested as columnar protrusions, and in 2 patients, ADF manifested as dome-shaped protrusions. For all 5 patients, the diameters of the lesions were <1 cm. Clinically, all 5 patients were misdiagnosed (ie, eccrine poroma (EP), common warts, rudimentary polydactyly, pyogenic granuloma (PG), and acral fibroma). All cases of ADF were confirmed by histopathology. The histopathological manifestations of ADF were as follows: finger-like protrusions on the skin surface; collagen fiber bundles running vertically to the epidermis seen in the dermis; and thick red-stained collagen fibers connected with the normal dermal connective tissue below. All 5 patients underwent surgical resection; the distance between the incision margin and the edge of the tumor was 2-3 mm, and the surgical depth was the deep dermis. No recurrence was observed in more than half a year of follow-up after surgery.

A retrospective study on the clinical features of skin lesions in Chinese acquired digital fibrokeratoma patients

BACKGROUND

Acquired digital fibrokeratoma (ADFK) is an uncommon benign fibro-epithelioma, which is rarely reported in China.

AIMS

To analysis the clinical features of ADFK in Chinese people from current cases.

METHODS

From December 2019 to October 2021, there were 21 patients diagnosed with ADFK, we made a retrospective analysis on the clinical features of skin lesions in them. To summarize the clinical morphology, location, and surgical follow-up of ADFK.

RESULTS

We concluded that ADFK is more common in females than males on the hands (7:3), while the male-to-female ratio is largely the same in feet (6:5). It occurs more frequently on the third finger (60%) and first toe (45.5%). As to clinical morphology, it is typically rod-shaped (52.4%), followed by dome-shaped (42.8%) and wart-shaped (4.8%). It is typically dome-shaped on the hands (80%) and rod-shaped on the feet (81.8%). In terms of location on the fingers (toes), such skin lesions are most common at the proximal nail fold (52.4%), which can also occur at the nail matrix (14.3%), periungual area (23.8%), and subungual area (9.5%). Nevertheless, this ratio also varies on the hands and feet. All patients got surgical excision of the skin lesion, who were followed up for 6-12 months, without recurrence.

CONCLUSIONS

Most ADFKs are associated with trauma, whose clinical features are related to location and gender. ADFKs on the hands are different from those on the feet regarding clinical morphology and location on fingers (toes), and surgery is effective in treating this condition.

Acquired Digital Fibrokeratoma

Acquired digital fibrokeratoma is a rare, benign tumor that mostly occurs on the fingers and toes and may appear to be a supernumerary rudimentary digit. It generally affects adult men and appears as a dome-shaped papule although it can also be elongated or pedunculated. Trauma is believed to be a triggering factor in some cases. We report a male patient with an acquired digital fibrokeratoma on a finger, shaped like a cutaneous horn, and a history of minimal repeated trauma and spontaneous remissions not previously described in the literature.

Acquired Digital Fibrokeratoma of the Toe

Acquired digital fibrokeratoma is a rare and benign fibrous tumor; it is usually asymptomatic, and frequently arises from the fingers. The diagnosis is easily confirmed by pathologic evaluation. However, in some cases, it may be misdiagnosed as other benign conditions, mainly adnexal tumors and common warts, especially when located on the foot and toes. In this article, we report the case of a 45-year-old man who presented to our clinic for an acquired growth over the plantar surface of the second right toe. The tumor had evolved for 1 year and affected the patient's activities and mobility. On examination, the lesion was a dome-shaped, firm tumor with keratotic distal changes and a broad base attached to the overlying skin. Pathologic assessment was consistent with the diagnosis of acquired digital fibrokeratoma, ruling out other causes of abnormal growth. The tumor was completely excised with surgery, with excellent outcomes and no recurrence at follow-up. Although acquired digital fibrokeratoma is a rare condition, mostly located on the distal upper extremities and fingers, it should be considered in the differential diagnosis of plantar soft-tissue tumors. Surgical management remains the mainstay of treatment.

Acquired Periungual Fibrokeratoma Looks like a Supernumerary Digit: An Uncommon Soft Tissue Tumor

Acquired digital fibrokeratoma is an uncommon, benign fibrous tumor that usually occurs in adults as a solitary lesion with a typical size of less than 1 cm. We present a case with periungual growth and nail plate deformity. The growth was completely excised after raising the epinychial flap and the fold was reconstructed. The histological results confirmed the digital fibrokeratoma. The rarity of digital fibrokeratoma and its unique morphological appearance of the tumor makes it interesting. Acquired periungual fibrokeratoma, an uncommon benign fibrous tumor of an unknown etiology, typically found at the distal end of the digits, may present with nail plate deformation due to chronic pressure, and in order not to damage the matrix, the tumor should be excised carefully, which can cause permanent nail dystrophy. In addition, we emphasize the importance of ruling out other causes of abnormal growths and of considering fibrokeratoma during differential diagnoses.

Acquired ungual fibrokeratoma: a systematic review of the literature

BACKGROUND

Acquired ungual fibrokeratomas (AUFKs) are benign recurrent fibrokeratotic tumors of the nail unit of uncertain etiology. Little is known about the optimal modality to successfully treat these lesions. No systematic review addressing ungual fibrokeratomas has been published to date.

OBJECTIVES

The aim of this study is to summarize all the published data regarding diagnostic and therapeutic challenges of AUFKs.

METHODS

On August 9, 2019, a systematic search of Medline and Cochrane databases was conducted. All the studies describing the treatment of ungual fibrokeratomas, procedure description, pathological findings, outcome, and follow-up period were included in this review.

RESULTS

After full-text article review, 103 articles were included, representing a total of 78 lesions. The commonly used treatments for fibrokeratomas were complete tumor resection (90.5%), shave excision (8.3%), and cryotherapy (1.2%). Complete surgical excision yielded the highest cure rate among all treatment modalities (90.8%) compared to partial surgical excision (28.6%) and cryotherapy (0%). The mean follow-up period was 12.1 months (1-144).

CONCLUSION

Complete surgical removal preserving the matrix showed the highest cure rates and should be considered as first-line treatment for AUFKs. Future adequately designed randomized control trials are warranted to compare different treatment modalities.

Cellular Digital Fibroma: A Comprehensive Review of a CD34-Positive Acral Lesion of the Distal Fingers and Toes

Cellular digital fibroma is a benign fibrous lesion that typically occurred on either a finger or a toe. Cellular digital fibroma was introduced as a distinctive cluster of differentiation 34 (CD34)-positive lesion in July 2005. Cellular digital fibroma has been described in 20 patients: 12 men and 8 women. The patients ranged in age from 27 to 83 years old (median, 52 years old) at diagnosis. The tumor had been present from 2 months to 2 years (median, 11 months) prior to seeking medical attention. The cellular digital fibroma was usually slowly growing and asymptomatic; there has been no prior history of trauma at the tumor site. The lesion typically presented as either an erythematous or a flesh-colored, solitary papule of 5 mm or smaller. It frequently occurred on either the dorsal, lateral or ventral side of a digit. Yet, some of the lesions were located on the nail fold of the digit. Cellular digital fibroma shows a prominent cellular proliferation of spindle-shaped fibroblasts, without any atypia or mitoses, that extends from the papillary into the upper reticular dermis; diffuse and strongly positive CD34 staining is present throughout the entire tumor. There is no erosion by the tumor of the bony phalanx. Other acral tumors, such as superficial acral fibromyxoma (which also has diffuse strongly positive CD34 staining) and acquired digital fibrokeratoma (which is either CD34-negative or only focal CD34 positive), are in the clinical and pathologic differential diagnosis of cellular digital fibroma. Conservative complete excision is the treatment of cellular digital fibroma; however, even for tumors that have only been partially removed during biopsy, recurrence has not been observed. In conclusion, cellular digital fibroma is a unique CD34-positive acral lesion of the distal fingers and toes whose diagnosis requires correlation of the clinical morphology and the pathologic features of the tumor.

Acquired digital fibrokeratoma: a rare case study

Acquired digital fibrokeratomas are a benign soft tissue tumor with typical appearance and anatomical locations. This lesion generally occurs in middle aged males with common sites of occurrence in the digits of upper or lower extremities. Previous case studies have reported incidences of this lesion appearing on heels of middle-aged males but are generally described as giant digital fibrokeratoma based on the lesion's diameter. This case report describes an acquired digital fibrokeratoma in a pediatric female patient in an infrequent location.

Acquired digital fibrokeratoma: review of its clinical and dermoscopic features and differential diagnosis

Acquired digital fibrokeratoma (ADFK) is a rare, benign, fibrous tumor that most often occurs on fingers. It may resemble a rudimentary supernumerary digit and is often misdiagnosed as another common benign condition, such as common wart. It is typically asymptomatic and occurs as a solitary nodule less than 1 cm in diameter. Oftentimes ADFK shares clinical and/or histologic resemblance with other benign and malignant cutaneous conditions so it is crucial that careful examination is undertaken. In this article, we will discuss the clinical presentation, epidemiology, etiology, dermoscopic and histologic findings, management, and differential diagnoses for ADFK, with the hope that this review will facilitate timely diagnosis and management for this distinct condition.

Acral Fibrokeratoma A Rare Pedal Soft-Tissue Mass

Acral fibrokeratoma is a rare soft-tissue mass, more commonly found on the hands and rarely on the feet. This case report of a 40-year-old Hispanic man highlights an unusually located acral fibrokeratoma on the second toe, describes the clinical presentation and microscopic and pathologic findings, discusses differential diagnoses, and presents treatment options.

Giant fibrokeratoma, a rare soft tissue tumor presenting like an accessory digit, a case report and review of literature

INTRODUCTION

Acquired digital fibrokeratoma is an uncommon, benign fibrous tumour that usually occurs in adults as a solitary lesion with a typical size of less than 1cm.

CASE PRESENTATION

A 48-year-old Afro-Caribbean man presented to our foot and ankle clinic with a long-standing growth over the plantar aspect of the distal phalanx of the left great toe. The growth was painful and affected the patient's mobility. It had gradually increased in size over a period of 17 years. The growth was completely excised, and the base was allowed to heal by secondary intention. The skin eventually healed, and the patient had a good outcome. The histological results confirmed that the growth was a digital fibrokeratoma.

CONCLUSION

This case is of interest because of the rarity of digital fibrokeratoma and the unique morphological appearance of the tumor in this case. Additionally, we emphasise the importance of ruling out other causes of abnormal growths and considering fibrokeratoma during differential diagnoses.

Giant acquired periungual fibrokeratoma of the thumb: case report and review

Fibrokeratoma is a benign fibrous tumor which usually arises in fingers and toes. Tumor size is usually small, around 3-5 mm. We report a giant acquired periungual fibrokeratoma of the thumb in this study. The size of the tumor is 40 × 25 × 21 mm(3). Clinical and histopathological characteristics of acquired fibrokeratoma are also reviewed.

Benign subungual tumors

A variety of benign and malignant processes may affect the subungual region; however, most are relatively rare lesions. We present a review of the current literature regarding benign tumors affecting the subungual region.