Clinical Challenge: Enlarging Growth at the Base of the Thumb

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A 52-year-old man requests removal of a growth at the base of his thumb. The lesion was first noted approximately 18 months ago and has been slowly enlarging. The lesion is subject to repeated trauma and is at times tender. Examination reveals a firm fixed flesh-colored nodule measuring 1.2 cm. No similar-appearing growths are noted elsewhere. The patient is in good health and denies history of arthritis and gout.

Cellular Digital FibromaAcquired digital fibrokeratomas are uncommon benign solitary tumors that most commonly arise on the fingers.1 The incidence is greatest in middle-aged men.2 Clinically, lesions are dome-shaped, flesh-colored, hyperkeratotic nodules that are fixed to underlying tissue. Repetitive trauma is believed to be...

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Cellular Digital Fibroma

Acquired digital fibrokeratomas are uncommon benign solitary tumors that most commonly arise on the fingers.1 The incidence is greatest in middle-aged men.2 Clinically, lesions are dome-shaped, flesh-colored, hyperkeratotic nodules that are fixed to underlying tissue. Repetitive trauma is believed to be a predisposing factor.3

Cellular digital fibromas are a rare subset of acquired digital fibrokeratomas first described in 2005.4 These lesions are composed of spindle-shaped CD34-positive cells. Histopathologic similarity to dermatofibrosarcoma protuberans has been noted. No cases of malignant degeneration have been reported with either tumor, and surgical excision is curative.

References

  1. Kint A, Baran R, De keyser H. Acquired (digital) fibrokeratoma. J Am Acad Dermatol. 1985;12(5 Pt 1):816-821.
  2. Altman DA, Griner JM, Faria DT. Acquired digital fibrokeratoma. Cutis. 1994;54(2):93-94.
  3. Baykal C, Buyukbabani N, Yazganoglu KD, Saglik E. Acquired digital fibrokeratoma. Cutis. 2007;79(2):129-132