Sclerotic fibroma

Sclerotic fibroma is a type of cutaneous condition that is characterized by the presence of a solitary, firm, skin-colored nodule. It is a rare benign fibrous tissue tumor that is often associated with Cowden syndrome, a genetic disorder that increases the risk of certain types of cancer.

Clinical Presentation

Sclerotic fibroma typically presents as a solitary, firm, skin-colored nodule that is less than 1 cm in diameter. It is most commonly found on the trunk, but can also occur on the extremities, head, and neck. The lesion is usually asymptomatic, but may cause discomfort or cosmetic concern.

Pathology

Histologically, sclerotic fibroma is characterized by a well-circumscribed dermal nodule composed of dense, hyalinized collagen bundles. The collagen bundles are often arranged in a storiform pattern and are interspersed with small, spindle-shaped fibroblasts. There is usually a sparse inflammatory infiltrate, and the overlying epidermis is typically unremarkable.

Diagnosis

The diagnosis of sclerotic fibroma is typically made based on the clinical presentation and histopathological findings. Other conditions that may be considered in the differential diagnosis include dermatofibroma, neurofibroma, and keloid.

Treatment

Treatment of sclerotic fibroma is usually not necessary, as the condition is benign and often asymptomatic. However, if the lesion is causing discomfort or cosmetic concern, it can be removed surgically.

Association with Cowden Syndrome

Sclerotic fibroma is often associated with Cowden syndrome, a genetic disorder characterized by multiple hamartomas and an increased risk of certain types of cancer, including breast, thyroid, and endometrial cancer. Individuals with Cowden syndrome often have multiple sclerotic fibromas.

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