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Fibrous Tumors of the Skin

»	What are tumors of fibrous tissue?
»	What is an acrochordon?
»	Is there a known cause for acrochordons?
»	Are any complications associated with acrochordons?
»	Are acrochordons associated with intestinal polyposis?
»	How can acrochordons be treated?
»	What is a hypertrophic scar?
»	What is a keloid?
»	List the clinical features useful in distinguishing hypertrophic scars from keloids.
»	Do any factors predispose to hypertrophic scars and keloids?
»	List the anatomic regions of the body that are most at risk to develop keloids.
»	Are there effective treatments for hypertrophic scars and keloids?
»	What is an acquired digital fibrokeratoma?
»	Has a cause been identified for acquired digital fibrokeratoma?
»	How can an acquired digital fibrokeratoma be treated?
»	What is nodular fasciitis?
»	What is a connective tissue nevus?
»	Why are connective tissue nevi important?
»	What is the gene defect in Buschke-Ollendorf syndrome?
»	What is infantile digital fibromatosis?
»	Describe the natural history of infantile digital fibromatosis.
»	What is a dermatofibroma?
»	What is a positive “dimple” sign?
»	Do dermatofibromas transform into skin cancer?
»	What is the best way to treat a dermatofibroma?
»	Are multiple dermatofibromas associated with any internal diseases?
»	What is a “fibrous papule of the nose”?
»	How is a fibrous papule of the nose best treated?
»	What are “giant cell tumors of the tendon sheath”?

Describe the natural history of infantile digital fibromatosis.

Infantile digital fibroma. Firm skin-colored nodule with focal hemorrhage on the finger of an infant. (Courtesy of the Fitzsimons Army Medical Center teaching files.)

Fig. 43.5 Infantile digital fibroma. Firm skin-colored nodule with focal hemorrhage on the finger of an infant. (Courtesy of the Fitzsimons Army Medical Center teaching files.)

The tumors of infantile digital fibromatosis may grow up to 2 cm but will eventually regress over a period of years (Fig. 43-5). Occasionally, large lesions may produce functional impairment or joint deformities.

The recurrence rate is very high, with up to two thirds of all cases recurring following surgical removal. The importance of this tumor is that physicians not familiar with the natural history of this tumor may become overly aggressive and amputate a digit.