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Starace M, Rapparini L, Quadrelli F, Cedirian S, Pampaloni F, Piraccini BM. When onychoscopy makes the difference in a longitudinal furrow on the nail plate: Myxoid pseudocyst versus ungual fibrokeratoma. J Eur Acad Dermatol Venereol 2024. [PMID: 38459785 DOI: 10.1111/jdv.19945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/19/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Pampaloni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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2
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Wang X, Zhang D, Lin Q, Niu C, Fan H, Zhang M, Yuan X, Ma W. Acquired Digital Fibrokeratoma: A Report of Five Cases and Review of the Literature. Clin Cosmet Investig Dermatol 2024; 17:247-252. [PMID: 38314146 PMCID: PMC10838103 DOI: 10.2147/ccid.s447798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/22/2024] [Indexed: 02/06/2024]
Abstract
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.
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Affiliation(s)
- Xing Wang
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Dong Zhang
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Qingxia Lin
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Changying Niu
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Huiping Fan
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Mogen Zhang
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Xiangfeng Yuan
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
| | - Weiyuan Ma
- Department of Dermatology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, People's Republic of China
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3
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Liu Y, Zhu Y, Chen G, Xu H, Rao Y, Liu K. A retrospective study on the clinical features of skin lesions in Chinese acquired digital fibrokeratoma patients. J Cosmet Dermatol 2024; 23:172-178. [PMID: 37365981 DOI: 10.1111/jocd.15889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
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.
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Affiliation(s)
- Yang Liu
- Department of Dermatology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yueqian Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Guodong Chen
- Department of Orthopedics, Cheng Wu People's Hospital, Heze, China
| | - Hui Xu
- Department of Dermatology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yamin Rao
- Department of Pathology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ke Liu
- Department of Dermatology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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4
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Navea OV, Navea MB, De la Fuente R. Acquired Digital Fibrokeratoma. Cureus 2023; 15:e47997. [PMID: 38034253 PMCID: PMC10686781 DOI: 10.7759/cureus.47997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
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.
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Affiliation(s)
- Oscar V Navea
- General Practice, Universidad de los Andes, Santiago, CHL
| | - Maria B Navea
- General Practice, Universidad de Chile, Santiago, CHL
| | - Raul De la Fuente
- Dermatology, Hospital Clínico de la Universidad de Chile, Santiago, CHL
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5
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Lee T, Huang Y, Wang J, Lin Z. Bilateral Symmetrical Nodules on the Thumbs in a Female Patient: A Quiz. Acta Derm Venereol 2023; 103:adv11143. [PMID: 37587666 PMCID: PMC10442924 DOI: 10.2340/actadv.v103.11143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/20/2023] [Indexed: 08/18/2023] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- TungChun Lee
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen 361026, China
| | - YiKe Huang
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen 361026, China
| | - Juan Wang
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen 361026, China.
| | - Zhimiao Lin
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen 361026, China.
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6
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Inamadar A, Mutalik S. Giant acquired digital fibrokeratoma. BMJ Case Rep 2023; 16:e254499. [PMID: 36731948 PMCID: PMC9896208 DOI: 10.1136/bcr-2022-254499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Arun Inamadar
- Department of Dermatology, Venereology & Leprosy, Shri BM Patil Medical College, Bijapur, India
| | - Sharad Mutalik
- Department of Dermatology, Venereology & Leprosy, Joshi Hospital, Pune, Maharashtra, India
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7
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Wang LL, Abbott JJ, Jiang AJ, Hannah C, Rubin AI. Pleomorphic acquired digital fibrokeratoma: A novel clinicopathologic entity. J Cutan Pathol 2023; 50:131-133. [PMID: 36050824 DOI: 10.1111/cup.14320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/02/2022] [Accepted: 08/28/2022] [Indexed: 01/24/2023]
Abstract
A 26-year-old male presented with a 2-year history of a hyperkeratotic growth from the left index finger. Histopathology was consistent with an acquired digital fibrokeratoma with changes of a pleomorphic fibroma. Lesional cells were negative for CD34, Rb, and p53, and were positive for FXIIIa. We introduce the pleomorphic acquired digital fibrokeratoma as a novel clinicopathologic entity.
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Affiliation(s)
- Leo L Wang
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - James J Abbott
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Angela J Jiang
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Claire Hannah
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Adam I Rubin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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8
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Starace M, Rubin AI, Di Chiacchio NG, Pampaloni F, Alessandrini A, Piraccini BM, Iorizzo M. Diagnosis and surgical treatment of benign nail unit tumors. J Dtsch Dermatol Ges 2023; 21:116-129. [PMID: 36808456 DOI: 10.1111/ddg.14942] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/25/2022] [Indexed: 02/22/2023]
Abstract
Little is known about benign non-melanocytic nail tumors, probably due to their low pathogenicity. They are commonly misdiagnosed as inflammatory or infective diseases. They have various features, depending on the type of tumor and its location in the nail apparatus. The typical sign of a tumor is the presence of a mass and/or secondary nail changes from damaged nail structures. In particular, if a single digit is affected by a dystrophic sign or a symptom is reported without any explanation, the presence of a tumor should always be ruled out. Dermatoscopy helps to enhance visualization of the condition and in many cases supports the diagnosis. It may also assist in identifying the right place to biopsy, but it never replaces surgery. Most common non-melanocytic nail tumors are analyzed in this paper, including glomus tumor, exostosis, myxoid pseudocyst, acquired fibrokeratoma, onychopapilloma, onychomatricoma, superficial acral fibromyxoma and subungual keratoacanthoma. The aim of our study is to review the main clinical and dermatoscopic characteristics of the most common benign non-melanocytic nail tumors, to correlate them with the histopathology and to advise practitioners of the best surgical management.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Ital
| | - Adam I Rubin
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, PA and Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | | | - Francesca Pampaloni
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Ital
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Ital
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
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9
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Starace M, Rubin AI, Di Chiacchio NG, Pampaloni F, Alessandrini A, Piraccini BM, Iorizzo M. Diagnose und chirurgische Behandlung gutartiger Tumoren der Nägel. J Dtsch Dermatol Ges 2023; 21:116-130. [PMID: 36808451 DOI: 10.1111/ddg.14942_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/25/2022] [Indexed: 02/22/2023]
Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Adam I Rubin
- Department of Dermatology, Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, PA and Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | | | - Francesca Pampaloni
- Dermatology Unit, Department of Medicine, University of Padova, Via Gallucci 4, 35121, Padova, Italy
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
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10
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Daneshjou R, Vodrahalli K, Novoa RA, Jenkins M, Liang W, Rotemberg V, Ko J, Swetter SM, Bailey EE, Gevaert O, Mukherjee P, Phung M, Yekrang K, Fong B, Sahasrabudhe R, Allerup JAC, Okata-Karigane U, Zou J, Chiou AS. Disparities in dermatology AI performance on a diverse, curated clinical image set. SCIENCE ADVANCES 2022; 8:eabq6147. [PMID: 35960806 PMCID: PMC9374341 DOI: 10.1126/sciadv.abq6147] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/30/2022] [Indexed: 06/10/2023]
Abstract
An estimated 3 billion people lack access to dermatological care globally. Artificial intelligence (AI) may aid in triaging skin diseases and identifying malignancies. However, most AI models have not been assessed on images of diverse skin tones or uncommon diseases. Thus, we created the Diverse Dermatology Images (DDI) dataset-the first publicly available, expertly curated, and pathologically confirmed image dataset with diverse skin tones. We show that state-of-the-art dermatology AI models exhibit substantial limitations on the DDI dataset, particularly on dark skin tones and uncommon diseases. We find that dermatologists, who often label AI datasets, also perform worse on images of dark skin tones and uncommon diseases. Fine-tuning AI models on the DDI images closes the performance gap between light and dark skin tones. These findings identify important weaknesses and biases in dermatology AI that should be addressed for reliable application to diverse patients and diseases.
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Affiliation(s)
- Roxana Daneshjou
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford, CA, USA
| | - Kailas Vodrahalli
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Roberto A. Novoa
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
- Department of Pathology, Stanford School of Medicine, Stanford, CA, USA
| | - Melissa Jenkins
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Weixin Liang
- Department of Computer Science, Stanford University, Stanford, CA, USA
| | - Veronica Rotemberg
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Justin Ko
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Susan M. Swetter
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Elizabeth E. Bailey
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Olivier Gevaert
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford, CA, USA
| | - Pritam Mukherjee
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford, CA, USA
| | - Michelle Phung
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Kiana Yekrang
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Bradley Fong
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Rachna Sahasrabudhe
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Johan A. C. Allerup
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | | | - James Zou
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
- Department of Computer Science, Stanford University, Stanford, CA, USA
- Chan-Zuckerberg Biohub, San Francisco, CA, USA
| | - Albert S. Chiou
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
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11
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Tognetti L, Bertello M, Cinotti E, Rubegni P. Acquired digital fibrokeratoma: First observation by high-resolution skin ultrasound and line-field confocal optical coherence tomography. Indian J Dermatol Venereol Leprol 2022; 88:275. [PMID: 35138053 DOI: 10.25259/ijdvl_1236_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 10/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena (Italy)
| | - Martina Bertello
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena (Italy)
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena (Italy)
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena (Italy)
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12
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Palaniappan V, Sadhasivamohan A, Sankarapandian J, Karthikeyan K. Acquired fibrokeratoma: A retrospective study in a tertiary centre in South India. Indian J Dermatol 2022; 67:312. [PMID: 36386073 PMCID: PMC9644781 DOI: 10.4103/ijd.ijd_239_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Acquired fibrokeratoma (AFK) is an uncommon, sporadic, benign, acquired, slow-growing dermo-epidermal tumour. Aims and Objectives: The purpose of this study was to summarize the demographic, clinical characteristics and treatment outcomes of patients with AFK in a tertiary care centre in South India. Methods: We evaluated the records of 26 patients with AFK who were diagnosed and treated in our centre between January 2017 and December 2021. The retrospective data related to age, sex, occupation, consistency, duration of lesions, history of trauma, anatomical site, morphological appearance, histopathological type, treatment provided and recurrence were taken into account and analysed. Results: Of the 26 patients, there were 21 males and 5 females. Fingers (n = 23) were the most common site involved, followed by toes (n = 2) and palm (n = 1). A total of 18 patients had finger-like projected lesions and eight patients had dome-shaped lesions. In histopathology, Type I AFK type was observed in 16 cases and Type II in 10 cases. Conclusion: We believe that our study would contribute by providing the clinical, histopathology and treatment outcomes of this uncommon dermo-epidermal tumour. The frequency of this condition is often underestimated as it is misdiagnosed for many other dermatological conditions.
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13
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Gara S, Zaouak A, Brahim EB, Jouini R, Fenniche S, Hammami H. Acquired Digital Fibrokeratoma of the Toe. J Am Podiatr Med Assoc 2021; 111. [PMID: 35294160 DOI: 10.7547/20-215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
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.
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Goh JY, Chan MMF, Oh CC. Feelers projection of the toe. JAAD Case Rep 2021; 12:91-93. [PMID: 34041342 PMCID: PMC8144101 DOI: 10.1016/j.jdcr.2021.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jia Yi Goh
- Department of Dermatology, Singapore General Hospital, Singapore
| | | | - Choon Chiat Oh
- Department of Dermatology, Singapore General Hospital, Singapore
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15
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Oba MÇ, Uzunçakmak TK, Sar M, Serdaroğlu S. Dermoscopic findings in a case of multiple subungual fibromas. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2021. [DOI: 10.15570/actaapa.2021.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Cohen PR, Alpert RS, Calame A. Cellular Digital Fibroma: A Comprehensive Review of a CD34-Positive Acral Lesion of the Distal Fingers and Toes. Dermatol Ther (Heidelb) 2020; 10:949-966. [PMID: 32728848 PMCID: PMC7477026 DOI: 10.1007/s13555-020-00418-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Philip R Cohen
- San Diego Family Dermatology, National City, CA, USA.
- Touro University California College of Osteopathic Medicine, Vallejo, CA, USA.
- , 10991 Twinleaf Court, San Diego, CA, 92131, USA.
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Hao X, Mirkin G, Baglio RJ. Recurrent Familial Digital Fibrokeratoma: A Case Report. J Foot Ankle Surg 2019; 58:1036-1039. [PMID: 31350140 DOI: 10.1053/j.jfas.2019.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Indexed: 02/03/2023]
Abstract
Digital fibrokeratoma (DF) is an uncommon, benign, soft tissue tumor. It usually occurs sporadically in adult males, and its recurrence is rare when treated by means of surgical removal. To the best of our knowledge, we report here the first case of recurrent female familial DF. The mother's first DF, on her right hallux, was removed when she was 32 years of age, and her second fibrokeratoma, on the left fifth toe, was removed when she was 49 years of age, and then relapsed 3 years later. The daughter's first DF, on her left fifth toe, was excised when the daughter was 24 years of age and recurred 1 year later. Both the mother's and daughter's recurrent lesions were surgically excised and pathologically diagnosed as DF. Because both the mother's and daughter's DF occurred at relatively early ages, we believe that genetic factors might play a role in the tumorigenesis of DF in this family.
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Affiliation(s)
- Xingpei Hao
- Senior Scientist, Foot and Ankle Specialists of the Mid-Atlantic, LLC, Rockville, MD
| | - Gene Mirkin
- Surgeon, Foot and Ankle Specialists of the Mid-Atlantic, LLC, Kensington, MD
| | - Robert J Baglio
- Surgeon, Foot and Ankle Specialists of the Mid-Atlantic, LLC, Charlottesville, VA.
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