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Fibrous papule of the nose

Author/s: Dr Amanda Oakley, Dermatologist, New Zealand, 2008. Updated: Dr Shawn Jordan, House Officer, ADHB; Honorary A/Prof Paul Jarrett, Dermatologist, CMDHB and Department of Medicine, The University of Auckland, New Zealand. Copy edited by Gus Mitchell. November 2021


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What is a fibrouspapuleof the nose?

A fibrous papule of the nose is a common and harmless skinlesion. It is a firm solitary papule that occurs on or around the nose and has a characteristic appearance under themicroscope.

A fibrous papule of the nose may also be known as a fibrous papule of the face, solitary血管纤维瘤, or sporadic angiofibroma.

Who gets fibrous丘疹?

Fibrous papules are common and may affect anyone. They usually appear during late adolescence and early adulthood. Multiple fibrous papules can be present without any underlying disorder.

The presence of multiple fibrous papules may be associated withgeneticconditions includingtuberous sclerosis,Birt-Hogg-Dubésyndrome, and multipleneuroendocrineneoplasiatype 1 (MEN1). In these conditions, the papules are numerous andwidespread, often beyond the nasal area. They are harmless apart from the psychological problems they may cause due to their visible appearance.

What causes fibrous papules?

The cause of fibrous papules is not known.

What are the clinical features of fibrous papules?

They are often a single solitary lesion on or around the nose. The fibrous papule of the nose is dome-shaped, firm, non-tender, measuring approximately 1–6 mm in diameter. It can be skin-coloured,pigmented, white, or red in colour.

Fibrous papule of the nose

What are the complications of fibrous papules?

Fibrous papules arebenignwith nomalignantpotential.

How are fibrous papules diagnosed?

A fibrous papule is diagnosed by skinbiopsy.

There are distinctivemicroscopicfeatures including:

  • Proliferationoffibroblasts, stellate, spindle, andmultinucleatedcells
  • Afibroticstroma
  • Dilatedblood vessels.

Many of thehistologicalfeatures may also be seen in other types of血管纤维瘤sand it can be difficult to distinguish themhistologically. For this reason, a fibrous papule is currently considered to be a variant of angiofibroma. There are several histological subtypes of fibrous papules including:

  • Hypercellular
  • Clear cell
  • Pigmented
  • Granular
  • Epithelioid
  • Pleomorphic
  • Inflammatory.

See also theclear cell fibrous papule病理page.

What is thedifferential diagnosisfor a fibrous papule?

Fibrous papules may be similar in appearance to other skinlesions. They can bedifferentiatedvia biopsy and other clinical features:

What is the treatment for a fibrous papule?

Fibrous papules are harmless, do not require any treatment, and remain stable. They may be removed for cosmetic reasons byshave biopsy,excision,cryotherapy,lasertherapy, andelectrosurgery.

Once removed, fibrous papules rarelyrecur.

References

  • Chan JY, Wang KH, Fang CL, Chen WY. Fibrous papule of the face, similar to tuberous sclerosis complex-associated angiofibroma, shows activation of the mammalian target of rapamycin pathway: evidence for a novel therapeutic strategy?. PLoS One. 2014;9(2):e89467. Published 2014 Feb 18. doi:10.1371/journal.pone.0089467.Journal
  • Damman J, Biswas A. Fibrous Papule: A Histopathologic Review. Am J Dermatopathol. 2018;40(8):551–60. doi:10.1097/DAD.0000000000001083.Journal
  • Sand M, Sand D, Thrandorf C, Paech V, Altmeyer P, Bechara FG. Cutaneous lesions of the nose. Head Face Med. 2010;6:7. Published 2010 Jun 4. doi:10.1186/1746-160X-6-7.Journal

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