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CASE #1
A 42-year-old man presented to the dermatology clinic complaining of a white-yellow papule that he had first noticed on his nose about three years ago. His history was noncontributory. Examination revealed a 3-mm domeshaped skin-colored papule on the right alar aspect of his nose.On dermoscopy,the lesion was noted to be erythematous, with arborizing telangiectasias.The papule was firm to the touch and totally symmetric.
CASE # 2
A 55-year-old man complained of small,soft,yellow papules on his nose and face.Numerous painless papules,ranging in size from 1 to 5 mm,were located on the nose,the glabellar area,cheeks,and forehead.Each lesion had a central umbilication from which the patient was able to express small quantities of a white fluid. Dermoscopy revealed a central aggregation of yellow nodules surrounded by groups of orderly winding vessels.
CASE #1 Fibrous papule
Clinically indistinct from many other diagnoses and very common, a fibrous papule is a benign asymptomatic variant of angiofibroma consisting of proliferations of stellate and spindle cells with dilated blood vessels and a fibrotic stroma in the upper dermis.The papules are symmetrical,dome-shaped, and skin-colored.They appear on the face-usually on the nose but also on the cheeks, chin, lips, neck, or forehead. No predilection has been found based on race or sex, but fibrous papules are usually seen between the third and fifth decades of life.The papules must be differentiated histologically from basal cell carcinoma (BCC),melanoma,and other serious lesions.
A number of fibrous papule subtypes have been described based on histologic findings.Each subtype has its own...