Acral fibrokeratoma
{{Infobox medical condition
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|synonyms = Acquired digital fibrokeratoma
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|specialty = Dermatology
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Acral fibrokeratoma, also known as an acquired digital fibrokeratoma, and acquired periungual fibrokeratomaFreedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. {{ISBN|0-07-138076-0}}.{{rp|668}} is a skin lesion characterized by a pinkish, hyperkeratotic, hornlike projection occurring on a finger, toe, or palm.James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. {{ISBN|0-7216-2921-0}}.{{rp|609}}{{cite book |author =Rapini, Ronald P. |author2 =Bolognia, Jean L. |author3 =Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |isbn=978-1-4160-2999-1 }}{{rp|1817}}
Signs and symptoms
Acral fibrokeratoma typically manifest as a non-symptomatic protuberance that does not go away on its own.{{cite journal | last1=Choi | first1=Joon Hee | last2=Jung | first2=So Young | last3=Chun | first3=Ji Sung | last4=Seo | first4=Jong Keun | last5=Lee | first5=Deborah | last6=Hwang | first6=Seon Wook | last7=Sung | first7=Ho Suck | title=Giant Acquired Digital Fibrokeratoma Occurring on the Left Great Toe | journal=Annals of Dermatology | publisher=Korean Dermatological Association and The Korean Society for Investigative Dermatology | volume=23 | issue=1 | year=2011 | pages=64–66 | issn=1013-9087 | doi=10.5021/ad.2011.23.1.64 | pmid=21738365 | pmc=3120001 }} In a clinical setting, it manifests as a single, well-defined, skin-colored papule with a distinctive hyperkeratotic collarette at the base.{{cite journal | last1=Lencastre | first1=André | last2=Richert | first2=Bertrand | title=Flat-Pan Nail-Wide Acquired Epiungual Fibrokeratoma: Report of 4 Cases | journal=Skin Appendage Disorders | publisher=S. Karger AG | volume=5 | issue=2 | date=2018-08-29 | issn=2296-9195 | doi=10.1159/000491582 | pages=111–113| pmid=30815446 | pmc=6388563 }} Though it can also be found in other places like the lower lip, nose, elbow, pre-patellar region, and periungual tissue, it mostly affects the fingers and toes.{{cite journal | last1=Kint | first1=André | last2=Baran | first2=Robert | last3=Keyser | first3=Hélène De | title=Acquired (digital) fibrokeratoma | journal=Journal of the American Academy of Dermatology | publisher=Elsevier BV | volume=12 | issue=5 | year=1985 | issn=0190-9622 | doi=10.1016/s0190-9622(85)70101-6 | pages=816–821| pmid=4008685 }} Usually, the lesion is smaller than 1 cm, however reports of acral fibrokeratomas larger than 1 cm, known as giant acral fibrokeratomas, have been made.{{cite journal | last1=Freitas | first1=Paula Martins de | last2=Xavier | first2=Marcus Henrique de SB | last3=Pereira | first3=Gabriela Blatt | last4=Rochael | first4=Mayra C | last5=Cortes | first5=José Luiz de Oliveira | last6=Quevedo | first6=Luis Peres | last7=Jr | first7=Adolpho A Araripe | title=Acquired fibrokeratoma presenting as a giant pedunculated lesion on the heel | journal=Dermatology Online Journal | volume=14 | issue=12 | date=2008-12-01 | issn=1087-2108 | doi=10.5070/D31TB5C7GQ | page=| pmid=19265623 }}{{cite journal | last1=Ali | first1=Mohammed | last2=Mbah | first2=C.A. | last3=Alwadiya | first3=Ahmed | last4=Nur | first4=Mutaz Mohammed | last5=Sunderamoorthy | first5=D. | title=Giant fibrokeratoma, a rare soft tissue tumor presenting like an accessory digit, a case report and review of literature | journal=International Journal of Surgery Case Reports | publisher=Elsevier BV | volume=10 | year=2015 | issn=2210-2612 | doi=10.1016/j.ijscr.2015.03.041 | pages=187–190| pmid=25863992 | pmc=4430176 }}
Causes
Although the exact cause of acral fibrokeratoma is unknown, prolonged irritation or trauma, particularly in the acral regions, have been suggested as potential contributing factors.{{cite journal |last1=Altman |first1=D A |last2=Griner |first2=J M |last3=Faria |first3=D T |title=Acquired digital fibrokeratoma |journal=Cutis |date=August 1994 |volume=54 |issue=2 |pages=93–94 |pmid=7956341}} In particular, it is thought that acral fibrokeratoma is exacerbated by recurrent trauma to the same location. This explains why the more frequently damaged areas are the acral regions, which are prone to severe trauma daily.{{cite journal | last1=Shih | first1=Shawn | last2=Khachemoune | first2=Amor | title=Acquired digital fibrokeratoma: review of its clinical and dermoscopic features and differential diagnosis | journal=International Journal of Dermatology | publisher=Wiley | volume=58 | issue=2 | date=2018-05-19 | issn=0011-9059 | doi=10.1111/ijd.14046 | pages=151–158| pmid=29777543 | s2cid=21743310 }}
Diagnosis
The histopathologic examination of acral fibrokeratoma usually shows hyperkeratosis and uneven acanthosis in the epidermis; dense, interwoven collagen bundles with dilated capillaries primarily oriented along the lesion's long axis comprise the lesion's core.{{cite journal | last1=Garg | first1=Shimona | last2=Sandhu | first2=Jasleen | last3=Kaur | first3=Amrit | last4=Punia | first4=Raj Pal Singh | title=Acquired Digital Fibrokeratoma | journal=The Journal of Clinical and Aesthetic Dermatology | date=2019 | publisher=Matrix Medical Communications | volume=12 | issue=5 | pages=17–18 | pmid=31320972 | pmc=6561713 }}
Treatment
There are reports of several treatment options for acral fibrokeratoma, including curettage, cauterization, shave excision, and cryotherapy. Nonetheless, surgical excision is regarded as the principal and most successful form of treatment.{{cite web | last1=Tabka | first1=Mariem | last2=Litaiem | first2=Noureddine | title=Acquired Digital Fibrokeratoma | publisher=StatPearls Publishing | date=2023-08-17 | pmid=31424730 |url=https://www.ncbi.nlm.nih.gov/books/NBK545146/ | access-date=2024-03-06}}
See also
References
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Further reading
- {{cite journal | last1=Qiao | first1=J. | last2=Liu | first2=Y. H. | last3=Fang | first3=K. | title=Acquired digital fibrokeratoma associated with ciclosporin treatment | journal=Clinical and Experimental Dermatology | publisher=Oxford University Press (OUP) | volume=34 | issue=2 | year=2009 | issn=0307-6938 | doi=10.1111/j.1365-2230.2008.02808.x | pages=257–259 | pmid=19187308 | s2cid=875312 | ref=none}}
- {{cite journal | last1=Sezer | first1=Engin | last2=Bridges | first2=Alina G | last3=Koseoglu | first3=Dogan | last4=Yuksek | first4=Jale | title=Acquired periungual fibrokeratoma developing after acute staphylococcal paronychia | journal=European Journal of Dermatology | publisher=John Libbey Eurotext | volume=19 | issue=6 | year=2009 | issn=1167-1122 | doi=10.1684/ejd.2009.0771 | pages=636–637 | pmid=19620034 | ref=none}}
External links
- [https://www.visualdx.com/visualdx/diagnosis/acquired+digital+fibrokeratoma?diagnosisId=53754&moduleId=101 VisualDx]
- [https://www.pathologyoutlines.com/topic/skintumornonmelanocyticacquireddigitalfibrokeratoma.html Pathology Outlines]
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{{Soft tissue tumors and sarcomas}}