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Acral fibrokeratoma

Acral fibrokeratoma
Other namesAcquired digital fibrokeratoma
SpecialtyDermatology

Acral fibrokeratoma, also known as an acquired digital fibrokeratoma, and acquired periungual fibrokeratoma[1]: 668  is a skin lesion characterized by a pinkish, hyperkeratotic, hornlike projection occurring on a finger, toe, or palm.[2]: 609 [3]: 1817 

Signs and symptoms

Acral fibrokeratoma typically manifest as a non-symptomatic protuberance that does not go away on its own.[4] In a clinical setting, it manifests as a single, well-defined, skin-colored papule with a distinctive hyperkeratotic collarette at the base.[5] 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.[6] 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.[7][8]

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.[9] 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.[10]

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.[11]

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.[12]

See also

References

  1. ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  2. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  3. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  4. ^ Choi, Joon Hee; Jung, So Young; Chun, Ji Sung; Seo, Jong Keun; Lee, Deborah; Hwang, Seon Wook; Sung, Ho Suck (2011). "Giant Acquired Digital Fibrokeratoma Occurring on the Left Great Toe". Annals of Dermatology. 23 (1). Korean Dermatological Association and The Korean Society for Investigative Dermatology: 64–66. doi:10.5021/ad.2011.23.1.64. ISSN 1013-9087. PMC 3120001. PMID 21738365.
  5. ^ Lencastre, André; Richert, Bertrand (2018-08-29). "Flat-Pan Nail-Wide Acquired Epiungual Fibrokeratoma: Report of 4 Cases". Skin Appendage Disorders. 5 (2). S. Karger AG: 111–113. doi:10.1159/000491582. ISSN 2296-9195. PMC 6388563. PMID 30815446.
  6. ^ Kint, André; Baran, Robert; Keyser, Hélène De (1985). "Acquired (digital) fibrokeratoma". Journal of the American Academy of Dermatology. 12 (5). Elsevier BV: 816–821. doi:10.1016/s0190-9622(85)70101-6. ISSN 0190-9622. PMID 4008685.
  7. ^ Freitas, Paula Martins de; Xavier, Marcus Henrique de SB; Pereira, Gabriela Blatt; Rochael, Mayra C; Cortes, José Luiz de Oliveira; Quevedo, Luis Peres; Jr, Adolpho A Araripe (2008-12-01). "Acquired fibrokeratoma presenting as a giant pedunculated lesion on the heel". Dermatology Online Journal. 14 (12). doi:10.5070/D31TB5C7GQ. ISSN 1087-2108. PMID 19265623.
  8. ^ Ali, Mohammed; Mbah, C.A.; Alwadiya, Ahmed; Nur, Mutaz Mohammed; Sunderamoorthy, D. (2015). "Giant fibrokeratoma, a rare soft tissue tumor presenting like an accessory digit, a case report and review of literature". International Journal of Surgery Case Reports. 10. Elsevier BV: 187–190. doi:10.1016/j.ijscr.2015.03.041. ISSN 2210-2612. PMC 4430176. PMID 25863992.
  9. ^ Altman, D A; Griner, J M; Faria, D T (August 1994). "Acquired digital fibrokeratoma". Cutis. 54 (2): 93–94. PMID 7956341.
  10. ^ Shih, Shawn; Khachemoune, Amor (2018-05-19). "Acquired digital fibrokeratoma: review of its clinical and dermoscopic features and differential diagnosis". International Journal of Dermatology. 58 (2). Wiley: 151–158. doi:10.1111/ijd.14046. ISSN 0011-9059. PMID 29777543. S2CID 21743310.
  11. ^ Garg, Shimona; Sandhu, Jasleen; Kaur, Amrit; Punia, Raj Pal Singh (2019). "Acquired Digital Fibrokeratoma". The Journal of Clinical and Aesthetic Dermatology. 12 (5). Matrix Medical Communications: 17–18. PMC 6561713. PMID 31320972.
  12. ^ Tabka, Mariem; Litaiem, Noureddine (2023-08-17). "Acquired Digital Fibrokeratoma". StatPearls Publishing. PMID 31424730. Retrieved 2024-03-06.

Further reading
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