Fibrous papule of the nose

Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 2008.

What is a fibrous papule?

A fibrous papule is a firm bump that most often occurs on the nose. It is very common. The fibrous papule has a characteristic appearance under the microscope.

What are the clinical features of fibrous papule?

A fibrous papule develops during late adolescence or early adult life on the nose, or less often, elsewhere on the face. It is a dome shaped shiny lesion 2-6 mm in diameter, sometimes bearing a central hair. Although it looks similar to a skin-coloured mole (dermal naevus), it is more firm in texture. It is harmless but persists unchanged lifelong.

It is important to distinguish fibrous papule from the common skin cancer, basal cell carcinoma, which may also present as a firm shiny bump. Basal cell carcinoma most often arises later in life. It slowly grows, and tends to bleed and ulcerate.

How is fibrous papule diagnosed?

Fibrous papule is diagnosed by skin biopsy. There are distinctive features on histopathology (proliferation of fibroblasts, fibrotic stroma, and dilated blood vessels).

What is the cause of fibrous papule?

Fibrous papule is considered a naevus, and develops spontaneously as part of human development. The precise reason is unknown.

How is fibrous papule treated?

Fibrous papule dose not require any treatment. If desired it may be removed by a minor surgical procedure (excision biopsy, shave biopsy or electrosurgery).

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