Exophytic Digital Lesion
Am Fam Physician. 2017 May 15;95(10):667-668.
A 36-year-old man presented with a self-described “wart” on his finger. It had been present since childhood, although he did not know if he was born with it. The lesion was a nuisance, but it did not itch or bleed and was nontender. It did not resolve with cryotherapy performed approximately 20 years earlier. He had no other similar lesions or significant medical history, including skin disease.
Physical examination revealed a 3-mm, exophytic, firm, flesh-colored filiform papule on the dorsum of the left third finger with slight scaling (Figure 1).
Based on the patient’s history and physical examination findings, which one of the following is the most likely diagnosis?
A. Acquired digital fibrokeratoma.
B. Common wart (verruca vulgaris).
C. Cutaneous horn.
D. Myxoid cyst (digital mucous cyst).
E. Supernumerary digit (polydactyly).
The answer is A: acquired digital
REFERENCESshow all references
1. Kakurai M, Yamada T, Kiyosawa T, Ohtsuki M, Nakagawa H. Giant acquired digital fibrokeratoma. J Am Acad Dermatol. 2003;48(5 suppl):S67–S68....
2. Satter EK. Acquired digital fibrokeratoma. January 23, 2017. http://emedicine.medscape.com/article/1055825-overview. Accessed March 18, 2017.
3. Cahn RL. Acquired periungual fibrokeratoma. A rare benign tumor previously described as the garlic-clove fibroma. Arch Dermatol. 1977;113(11):1564–1568.
4. Hashiro M, Fujio Y, Tanaka M, Yamatodani Y. Giant acquired fibrokeratoma of the nail bed. Dermatology. 1995;190(2):169–171.
5. Longhurst WD, Khachemoune A. An unknown mass: the differential diagnosis of digit tumors. Int J Dermatol. 2015;54(11):1214–1225.
This series is coordinated by John E. Delzell Jr., MD, MSPH, Assistant Medical Editor.
A collection of Photo Quiz published in AFP is available at https://www.aafp.org/afp/photoquiz.
Previously published Photo Quizzes are now featured in a mobile app. Get more information at https://www.aafp.org/afp/apps.
The editors of AFP welcome submissions for Photo Quiz. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors' Guide at http://www.aafp.org/afp/photoquizinfo. To be considered for publication, submissions must meet these guidelines. E-mail submissions to firstname.lastname@example.org.
Copyright © 2017 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions