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

Abstract

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.

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

“…Several other conditions are also in the clinical differential diagnosis. Some of these include acquired reactive digital fibroma, digital fibroma, periungual fibroma (referred to as a Koenen tumor located under the nail fold and associated with tuberous sclerosis when multiple lesions are present), and supernumerary digit and verruca vulgaris [ 29 , 34 , 35 ].…”

“…Acquired digital fibrokeratoma is almost always a single lesion on either a finger or a toes [ 9 , 29 , 38 ]. The morphology of acquired digital fibrokeratoma—a small, often less than 5 mm, solitary, dome-shaped, flesh-colored papule–can be clinically similar to that of a cellular digital fibroma, such as the lesion observed in the 61-year-old man in this report.…”

“…Acquired digital fibrokeratoma Acquired digital fibrokeratoma is almost always a single lesion on either a finger or a toes [9,29,38]. The morphology of acquired digital fibrokeratoma- CD cluster of differentiation, H&E hematoxylin and eosin, EMA epithelial membrane antigen, ?…”

Giant acquired acral fibrokeratoma: A case report

“…The diagnosis of our patient's lesion was based upon both clinical and histopathological findings. The Shih et al 17 stated that the diagnosis of AAF needs to be confirmed with an excisional biopsy since several conditions may clinically mimic AAF. Lee et al 18 added that the first line of treatment for AAF is surgical excision of the tumor, with very rare recurrence.…”

Feelers projection of the toe

“…From a histopathologic viewpoint, it has a hyperkeratotic acanthothic epidermis with collagen fibers along the vertical axis consistent with fibrokeratoma. 2 , 3 Pyogenic granuloma–Incorrect. Pyogenic granuloma can present as a friable, dome-shaped or pedunculated papule or polyp.…”